7/21/2026

[DVM Intake] DVM Intake Exam Estimated age: 5yrs based on dentition/conformation Microchip noted on intake? scans negative History: stray Subjective: QAR, Observed Behavior - hiding at back of kennel, tolerated all tasks/handling with occasional low growls, eating sardines well during exam Is there evidence of suspected cruelty? no Objective: P = 200 R = 24 BCS 2/9 EENT: Eyes clear, ears mild ceruminous debris AU, no nasal or ocular discharge noted Oral Exam: thick calculus with purulent discharge around molars bilaterally, remainder of teeth are adult teeth with moderate staining PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: MI; 2 testicles descended MSI: Ambulatory x 4, skin free of parasites, no masses noted, patchy alopecia with focal patches on left side of mandible, behind left ear, and scant haircoat on caudoventral abdomen, focal scabbing on hocks bilaterally with no open wounds discovered CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: externally normal Wood's Lamp Exam: negative Assessment: Approx. 5yr MI DSH Severe dental disease with thick calculus and pus surrounding molars Underconditioned Patchy alopecia (r/o infectious (flea allergy vs other ectoparasites) vs inflammatory/allergies vs other systemic disease) Prognosis: good pending diagnostics Plan: intake tasks CBC/Chem/T4 to idexx TID feeding Appetite monitoring log cleaned hocks with dilute chlorhex- no wounds discovered gabapentin 20mg/kg PO BID indefinitely for dental pain Rec dental once placed and pending labwork review DVM recheck in 24hrs to review labs and recheck appetite/comfort SURGERY: Temporary waiver due to underweight and comorbidities- recheck weight in 2 wks

7/24/2026

Recheck, bw results S/O: QAR at back of kennel, eating well, no c/s/v/d noted EENT: No ocular or nasal discharge LUNGS: Eupneic CNS: Appropriate mentation CBC: Hct 21.1 (L), reticulocytes 80 (H); lymphocytes 0.41 (L), monocytes 0.566 (H), eosinophils 0.123 (L) CHEM: BUN 70 (H), creatinine 1.0 (N) and SDMA 13 (N); potassium 3.6 (L), ALP 7 (L) T4: wnl A: Regenerative anemia - ro chronic disease vs blood loss vs other Elevated BUN - ro GI vs renal vs pre-renal Severe dental disease Underweight Alopecia Wound P: Clinically stable and doing well at this time Recheck scheduled next week, repeat bloodwork and reweigh at that time CTM while at QACC

7/27/2026

S: Noted to have FS 6 O: EENT: No ocular/nasal discharge, clear OU Mentation: BAR, hiding A: Diarrhea once 7/25 P: Add monitor sheet Monitor for worsening diarrhea, vomiting, weight loss, not eating/drinking

7/29/2026

S: Recheck, BW and reweigh O: WT: 5.9lb (prev 5.1lb) EENT: No nasal or ocular discharge Oral Exam: Severe dental disease, halitosis H/L: eupneic Abd: Soft, non-painful MSI: ambulatory x4, slightly unkempt haircoat, thin Mentation: BAR, appropriate mentation A: Severe dental disease Underweight Hx elevated BUN P: Send out CBC/Chem/T4 Continue to monitor

7/30/2026

CBC: Hct 29.4 (L), reticulocytes 124 (H); monocytes 0.475 (H), eosinophils 0.13 (L) CHEM: BUN 57 (H); ALT 20 (L), AST 14 (L), ALP 7 (L) Interpretation: -Anemia, regenerative - improving -Elevated BUN - improving -Decreased ALT, AST, ALP - no clinical significance PLAN: Significant improvement in bloodwork, gaining weight. Recommend dental procedure with placement. CTM while at QACC.

7/30/2026

S: Persistent diarrhea noted the last few days. O: BAR, eating well. BW has improved significantly since in care. A: Diarrhea P: Start fortiflora SID x 7 days. Place monitoring sheet. Recheck placed in 3 days to monitor.

8/3/2026

Recheck diarrhea Normal appetite, no c/s/v. No diarrhea noted on monitoring sheet. Continue fortiflora, no additional medications needed.

8/7/2026

recheck congestion and anorexia. QAR, lethargic. Patient has severe hemorrhagic/purulent oral discharge. Moderate yellow NDC and crusting noted. Oral exam: Severe dental and periodontal disease. No obvious masses or abnormal swellings on brief oral exam. Patient has hyperplasia of gingiva on tissue near sublingual salivary glands. A: Severe dental and periodontal disease Weight loss (5.4lb previously, 5lb today) Lethargic, QAR P: Move to ICU for intensive supportive care given the severity of disease SQ fluids 50ml Convenia 0.23ml SQ Onsior 0.23ml SQ Place on ARL list due to need for dental procedure ASAP. Recheck scheduled 8/8 to evaluate response.

8/8/2026

Recheck, low AS with severe hypersalivation and weight loss. in ICU on supportive care (SQ fluids 50ml SQ until 8/9, Onsior and convenia injections given once). Appears slightly more BAR today. Ate all food this AM. Severe congestion and moderate bloody hypersalivation and NDC. Diarrhea noted throughout the day A: Severe dental and periodontal disease Weight loss Lethargy Diarrhea P: Continue with supportive care SQ fluids Add Cerenia 0.23ml SQ SID x 3 days Extend SQ Fluids 50ml SID x 3 additional days Add Fortiflora SID x 7 days Recheck scheduled for 8/9. If patient declines, consider EHR. If stable, he is placed on ARL.

8/9/2026

Recheck severe hypersalivation and weight loss S/O: QAR, mildly prolonged skin tent Severe congestion and moderate bloody hypersalivation and NDC. Formed stool today and fair appetite. P not tolerant of oral exam, appears painful A: Severe dental and periodontal disease Weight loss Lethargy Diarrhea - improved today P: ADD Simbadol 0.3mL (~0.24mg/kg) SQ SID --> 8/11, do as AM tx to limit potential anesthetic interaction for procedure scheduled on 8/12 CWCP DVM recheck 8/10

8/10/2026

recheck, severe dental dz, underweight S/O QAR, no c/s/v/d appreciated or noted. Wet food mostly disturbed, dry food untouched EENT: no ocular dc, mild ptyalism (appears serous, thin), mucopurulent staining under the nares, audible congestion, would not allow for oral exam HL: eupneic MSI: amb x 4, good skin turgor A. Severe dental/periodontal dz noted prior Weight loss persists (4.87# today_ Mucopurulent staining and congestion r/o primary URI vs secondary to severe dental dz P. Moved to med-iso Add in doxy 10mg/kg PO SID x 10 days (0.44mL) Brief recheck tomorrow - if signs appear more consistent with URI rather than advanced dental dz, consider cancelling dental and extending simbadol for pain. URI rechecks CTM while at QACC

8/11/2026

DVM Progress Exam -Signs consistent with a URI per 8/10 report -Canceled dental procedure for 8/12; URI to resolve before proceeding with anesthesia -Extending Simbadol through 8/13 -Next URI recheck 8/13 with pathway and medication assessment -Officially placed on ARL on 8/11

8/13/2026

Recheck severe hypersalivation and weight loss S/O: BARH - fearful, flinches when touched, attempts to flee Mild congestion but only scant nasal discharge Formed stool today and great appetite - weight loss continues P not tolerant of oral exam, appears painful A: Severe dental and periodontal disease Weight loss - persists despite good appetite P: EXTEND SIMBADOL --> 8/15 Otherwise CWCP Discussion: Concern for underlying pathology other than dental disease given continued weight loss despite good appetite. Recheck 8/15 in AM - if no improvement in clinical condition / no pathway for placement consider EHR, P needs more diagnostics than is possisble in a shelter setting.

Upon intake Zero was fearful and allowed minimal handling.