10/27/2023

DVM Intake Exam Estimated age: 4-6y Microchip noted on Intake? scanned negative History: Injured stray cat kept by finder for 1 week on kennel rest. Subjective: BAR Observed Behavior - Head butting and seeking attention. Was able to climb on and off den in kennel. Allows all handling, more tense on slippery surface of scale. Evidence of Cruelty seen -no Evidence of Neglect seen-no Evidence of Trauma seen -yes, HL lameness bilaterally Objective T = P =wnl R =wnl BCS 4/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: adult dentition with moderate staining PLN: No enlargements noted H/L: NR, NMA, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: male intact, 2 scrotal testes MSI: Ambulatory x 4, but weak on HLs, skin free of parasites, no masses noted, healthy hair coat with few minor abrasions CNS: Mentation appropriate - bilateral HL paraparesis, anal tone present Rectal: normal external Wood's Lamp Exam: not performed Assessment spinal trauma suspected R stifle suspected cruciate tear L stifle patella dislocation Prognosis: fair Plan: intake tasks sedate for radiographs using 0.1ml dexmedetomidine 500mcg/ml, 0.1ml ketamine 100mg/ml, and 0.1ml butorphanol 10mg/ml IM-provided good sedation lateral and VD views of pelvis, thorax and lateral of each stifle Pelvis-no apparent fractures lumbar spine-possible subluxation of 2 caudal lumbar vertebrae L stifle patella appears displaced cranially, but on manipulation mild crepitus, but negative cranial drawer R stifle unremarkable appearance on radiograph, but positive cranial drawer with marked laxity Zorbium applied for 9lbs Robenacoxib 20mg/ml 0.5ml sc SID x3d SURGERY: Temporary waiver due to injuries

10/28/2023

Problem List: - Hindlimb paresis - Possible cruciate rupture/tear of R HL - Left HL patella cranially displaced on radiographs S: BAR, food bowls empty. Head bunting. O: EENT: Eyes clear, ears clean, no nasal or ocular discharge noted H/L: NR, NMA, Lungs clear, eupneic ABD: Non painful, no masses palpated U/G: MI MSI: Ambulatory x 4, weight baring but weak on HLs. Allows palpation of LHL but sensitive to palpation of RHL CNS: Mentation appropriate - HL paraparesis Rectal: Externally WNL A: HL paraparesis Possible RHL cruciate tear P: CWCT Recommend seeking placement for sx correction

10/29/2023

Issue List: - left sided patella luxation and possible stifle subluxation - h/o HL paraparesis but appears to be amb x 4 on presentation BAR H eating BM in litter pail EENT: no nasal or ocular discharge noted H/L: eupneic PLN: WNL ABD: relaxed U/G: MC MSI: Ambulatory x 4 but crouching gait in HL's CNS: Mentation quiet - no signs of neurologic abnormalities A) L HL injury possible spinal injury P) CWSC

10/30/2023

Onsior 6 mg 1 tablet po sid x 3 days.

10/30/2023

Pet urinated and defecated in box o/n. Eating well. EEN: No ocular or nasal discharge. RESP: Eupneic MSI: BCS 4/9 Ambul x 4. Laxity visible in right stifle and left stifle bows as he walks. Pet vocalizes when hind end is touched and resists exam. NEURO: No proprioceptive deficits. HL weakness but not ataxia. BAR A: HL lameness and weakness r/o stifle changes as previously described. DOH-B Prognosis: Fair. Expect chronic instability in stifles without surgery but pet appears happy when not palpated. P: Onsior 6 mg 1 tablet po sid x 3d starting tomorrow. Monitor

10/31/2023

On 10/31/2023 at approximately 11:12 AM, King was examined. The patient has appropriate mentation at this time. He has had some weakness in his hindlimbs but this appears to be attributed to an orthopedic injury. He does not appear to have neurologic deficits in his hindlimbs on presentation. Hx: on DOH for biting a person; left sided patella luxation and apparent stifle subluxation (r/o trauma) BAR H eating well; very social eent- no nasal and no ocular discharge hl- clear and eupneic msi- ambulatory x 4 but lameness on the left HL and reluctant to stand; bcs- 5/9 neuro- no apparent deficits but does have HL weakness A) no apparent neuropathy present but has orthopedic injuries in left hindlimb P) DOH-B observation

11/2/2023

SO: Bilateral HL stifle issues. Currently on rabies observation after bite incident BAR eyes clear, no ocular or nasal dc apparent eupneic, no coughing or sneezing appreciated ambulatory x4 with bilateral HL weakness mentation alert and appropriate A: bilateral HL lameness P: continue pain management

11/5/2023

Pet BAR. Ate well o/n and urinated in box. RESP: Eupneic. MSI: Ambul x 4 but instability in HLs as previously described. A: Stable Prognosis: Poor without surgery to correct instability in knees. Plan Advise orthopedic consultation for patella luxation and cruciate repair to increase comfort and behavior. Movet to holding Onsior 6mg 1 tablet po sid x 7d

11/10/2023

At approximately 10AM on 11/10/2023 King was examined, he was eating during interaction and would periodically look up at me. No signs of neurologic deficits or abnormalities were noted during the interaction or during his time at MACC. A: No signs of neurologic deficits or abnormalities P: Consider releasing from DOH hold Recommend placement for HL work up/orthopedic consult

11/15/2023

Hx: presents with URI QAR EENT- nasal discharge HL- 200hr reg nm UG- MC MSI- NSF A) URI mild P) B Vits- 1000microg/ml Sig: 0.25 ml sq or 0.10 ml sq SQ fluids- 100ml LRS

11/17/2023

SO: On treatment for mild URI with sc fluids and B12 injection BAR, in kennel, appears to be eating, but with decreased appetite eent: eyes clear, mucoid nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4 neuro: mentation alert and appropriate A: URI-moderate P: treat in place doxycycline 50mg/ml 0.8ml PO SID x7d fortiflora 1 packet PO SID x7d monitor appetite daily recheck in 7d

11/22/2023

Recheck moderate URI S: BAR, standing up right at kennel door, lightly paws at me, food bowls are empty O: EEN- eyes clear, clear nasal discharge but no ocular discharge noted H/L- Eupneic, no coughing/sneezing or audible congestion appreciated MSK- ambulatory x4 Neuro- alert/appropriate A: URI appears to be resolving Eating well P: CTM in care