1/23/2025

DVM Intake Exam Estimated age: 12y Microchip noted on Intake? scanned positive History: Owner passed away and was brought in by neighbor. Subjective: BAR Observed Behavior - Hissing and growling inside of den. Elected sedation using 0.15ml dexmedetomidine 500mcg/ml, 0.15ml ketamine 100mg/ml, 0.15ml butorphanol 10mg/ml IM Evidence of Cruelty seen -no Evidence of Neglect seen-no Evidence of Trauma seen -no Objective T = P =wnl R =wnl BCS 3/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: adult dentition with minor staining, mms pale, possible yellow tint PLN: No enlargements noted H/L: NR, NMA, Lungs clear, eupneic ABD: Non painful, possible segmental thickening of intestines on palpation U/G: female spayed, green tattoo present MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: normal external Wood's Lamp Exam: not performed Assessment underweight thickened intestines Prognosis: fair-guarded pending diagnostics Plan: intake tasks cbc/chem/T4 three view thoracic and abdominal radiographs SURGERY: already spayed

1/24/2025

Three view abdominal and thoracic radiographs suspect thickened segment of intestine was possibly transverse colon with material no other significant abnormalities noted on radiographs

1/24/2025

CBC/chem/T4 in house CBC HCT 19.9% (L) Chem BG 363 (H) ALP 200 (H) marked non regenerative or pre regenerative anemia hyperglycemia r/o stress v diabetes mellitus plan to collect urine for dipstick to monitor for urine glucose

1/24/2025

SO: Senior cat possible diabetes mellitus, but alos possible stress hyperglucemia BAR, laying inside of den, ate all wet food in kennel overnight. Small amount of urine in litter box 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: monitoring for hyperglycemia P: given no-sorb to attempt urine collection for dipstick

1/25/2025

SO: In medical on observation after increased BG on intake. BAR, inside of den, all wet food in kennel has been eaten. When approached growling and will swat. 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: possible diabetes mellitus P: urine sample collected from no-sorb litter Glucose 1+, possible trace ketones will send sample to lab for UA Sedated for placement of CGM 0.1ml dexmedetomidine 500mcg/ml, 0.1ml ketamine 100mg/ml and 0.1ml butorphanol 10mg/ml IM BG under sedation 214 on glucometer urine sample obtained via cysto to replace sample from no-sorb 100ml LRS sc 0.4ml cerenia sc once 0.25ml vitamin B12 sc once starting DM diet if will eat it if not consider lower carbohydrate fancy feast monitor BG, but not starting insulin at this time

1/25/2025

PM BG: 220 mg/dL on CGM As per Dr. 1697, no insulin.

1/26/2025

Urinalysis: Glucose 3+ concerned about DM; on special DM diet trace ketones PZI- 1 unit SQ q 12 hrs

1/26/2025

bg 169 at 12:08 pm

1/26/2025

bg 139 at 5pm skip insulin per dvm

1/28/2025

AM BG: 240 MG/DL PM BG: 183 MG/DL No insulin administered today

1/29/2025

SO: In medical on management of borderline diabetes mellitus BAR, growling when approached in kennel. Visual exam only 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: diabetes mellitus P: BG in AM 326 1 unit PZI sc administered

1/29/2025

AM BG: 324 MG/DL (Administered 1 unit PZI SQ) PM BG: 202 MG/DL (no insulin administered)

1/30/2025

SO: In medical on treatment for borderline diabetes QAR, curled up in den. Growling and swatting when approached to read CGM eent: eyes clear, no nasal dc apparent, mild yellow ocular dc apparent dried at medial canthus h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4 neuro: mentation alert and appropriate A: diabetes mellitus P: BG 206 in AM not eating fancy feast when offered skipping insulin in AM recheck BG in PM plan to collect urine overnight to check for ketones

1/30/2025

Nibbling at Fancy Feast through day mild head tremor noted

1/30/2025

Continued nibbling on Fancy Feast throughout day BG in PM= 176 skip insulin again

1/30/2025

AM BG: 206 mg/dL PM BG: 176 mg/dL As per Dr. 1697, no insulin administered today