5/9/2025

DVM Intake Exam Estimated age: 3-5 years years based on dentition Microchip noted on Intake? Scanned negative History: Acquired by ACO, deli cat that was noted to have blood on hindend Subjective: QAR Observed Behavior - tense, lip licking, allows handling but fearful. Sedated for exam and diagnostics using 0.3 ml Dexmedetomidine (500mcg/ml) + 0.3 ml Butorphanol (10mg/ml) + 0.3 ml Ketamine (100mg/ml) IM. Mild sedation reached. Is there evidence of Cruelty? No Is there evidence of Neglect? No Is there evidence of Trauma? No Objective T = P = WNL R = WNL BCS: 7/9 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: Lemon sized firm bladder palpated. U/G: Hematuria coming from prepuce, intact male, 2 scrotal testes MSI: Ambulatory x 4, skin free of parasites, no masses noted, urine soaked hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Externally WNL Wood's Lamp Exam: not performed Assessment Hematuria Urinary Obstruction Intact male Overweight Prognosis: Poor to fair Plan: Lateral radiograph (pre-unblocking)- no appreciable radio-opaque stones Unblocking procedure: Placed in dorsal recumbency, using 20G catheter tip the urethra was flushed and the urinary bladder was emptied A 3.5 in tomcat catheter was easily placed and sutured in place using 3-0 monocryl suture CBC/CHM in house Urinalysis to send out Place IV catheter, LRS 20ml/hr Zorbium at end of day for appropriate weight Await sort 0.15 ml antisedan IM SURGERY: Temporary waiver due to clinical status

5/9/2025

CBC HCT 37.7% Hgb 12.6 g/dL WBC 23 K/uL (2.87-17.02) - moderate neutrophilia 22.09 K/uL CHM Glucose 124 mg/dL SDMA 62 ug/dL (0-14) Creatinine 9.3 mg/dL (0.8-2.4) BUN > 130 mg/dL (16-36) Hyperphosphatemia 12.4 mg/dL (3.1-7.5) Hypernatremia 166 mmol/L Other lytes WNL ALT/ALP WNL A: Leukocytosis w/ neutrophilia- r/o inflammation vs. infection vs. other Azotemia- likely secondary to urinary obstruction Hyperphosphatemia + hypernatremia P: CWCT Recheck CHM when urinary cath removed (~3-4 days)

5/10/2025

SO: In medical on treatment post urinary obstruction BAR, tense and growling when handling, but does not escalate. eent: eyes clear, no ocular or nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4 abd: abd palp very tense unable to palpate bladder, u catheter in place neuro: mentation alert and appropriate A: FLUTD post obstruction Restarting IV fluids at 25ml/hr flushed urinary catheter and appears to be flowing well continue with current treatment plan P:

5/10/2025

UA at lab USG 1.019 Urine protein 3+ Blood 3+ RBC >100/hpf Bacteria moderate cocci (9-40/hpf) Urine culture pending

5/11/2025

Issue List: - FLUTD with UO - marked azotemia r/o post-renal vs renal vs both - anorexia - dehydration - FAS QAR DH; hissing; does not like to be touched EENT: no nasal or ocular discharge noted H/L: eupneic PLN: WNL ABD: non-palpable bladder U/G: MI; urinary catheter in place and appears to be flowing MSI: Ambulatory x 4, normal hair coat; overweight CNS: Mentation quiet - no signs of neurologic abnormalities A) FLUTD with UO Anorexia prognosis guarded P) Telazol- 0.16 ml IM for physical exam CWSC fluids- 25 ml/hr for 2-3 hears and then down 12 ml/hr

5/11/2025

Urine culture Mixed flora with 2 or more organisms with low growth. Suggests contamination Plan Consider repeat urine culture when u-cath removed

5/12/2025

Pet ate some wet food o/n. Urinated in box. Abdomen: Tense. Ucath in place and red urine flowing. MSI: Swollen left front paw distal to IVC A: Hematuria Appetite improving Pet is fractious and only tolerates minimal handling Prognosis: Poor Plan Removed IVC Simbadol 1.8 mg/ml 0.7 ml SQ sid x 2 days Pet would not tolerate SQF

5/13/2025

Small amount of urine in box. Pet did not eat overnight. Temp 102.5 EEN: No oral lesions CV/RESP: WNL Abdomen: Tense UG: Insufficient urine on aspirate of u-cath for culture Chem Kidney values WNL Phosphorous wnl Na high r/o decreased water intake Abdominal ultrasound: Small bladder with hyperechoic debris. Scant urine. Radiograph: Three round opacities visible in bladder A: Bladder stones Azotemia resolved Dehydrated Prognosis: Poor Plan Sedated with DKT feline pre-mix 0.5 ml IM (dexdomitor 0.0125 mg/kg + ketamine 100mg/ml 5mg/kg + butorphanol 10mg/ml 0.0125 mg/kg) LRS 150 mls SQ (pet will not tolerate this without sedation) Removed u-cath Convenia 80mg/ml 0.5 ml SQ Gabapentin 100mg bid in food c/d or s/o diet indefinitely Consider cystotomy rather than dissolution of stones with diet given pet's high stress level Advise at risk placement

5/14/2025

Issue List: - FLUTD with UO; post urinary catheter removal- getting urine out but appears to be dribbling and soiling self - Bladder stones - FAS QAR not eating EENT: no nasal or ocular discharge noted H/L: eupneic ABD: non-palpable bladder but tense U/G: MI MSI: Ambulatory x 4, soiled; overweight CNS: Mentation quiet A) FLUTD with UO Bladder stone prognosis guarded to poor P) Not the best candidate for PU because overweight and needs a cystotomy on ARL Onsior- 20 mg/ml sig: 0.5 ml SQ

5/15/2025

Hx: urinary obstruction, 3 small bladder stones noted on radiographs S: QAR, tightly coiled in litterbox, food untouched o/n. Flinches when approached. Unable to see if urinated in litterbox but none on bedding O: EENT: Eyes clear, no nasal or ocular discharge noted H/L: Eupneic, no coughing/sneezing or audible congestion MSI: Ambulatory x 4, healthy hair coat CNS: Mentation appropriate/alert A: Urinary obstruction Radio-opaque stones noted on repeat radiograph Anorexia High FAS P: CWCT Follow up with potential placement groups as QOL in shelter is deteriorating

5/15/2025

Urinated and defecated in litterbox