2/19/2026

DVM Intake Exam Estimated age: 2-4 years based on dentition Microchip noted on Intake? Scanned negative History: Stray, found in hallway Subjective: QAR Observed Behavior - tense but allows all handling, periodic tail flicking when abdomen palpated Is there evidence of Cruelty? No Is there evidence of Neglect? No Is there evidence of Trauma? No Objective T = P = 120 bpm R = WNL BCS: 4/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Adult dentition, mild tartar, pink/moist mm PLN: No enlargements noted H/L: bradycardia, no murmur noted, CRT < 2, Lungs clear, eupneic ABD: Firm turgid bladder. Painful, no masses palpated. U/G: Externally WNL, intact male, 2 scrotal testes MSI: weakly 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 Urinary obstruction Bradycardia/arrhythmia Intact male Prognosis: Guarded Plan: Sedate using DKT premix 0.3 ml IM AFAST: large bladder with hyperechoic debris Place IV catheter CBC/CHM in house Abdominal radiographs, large bladder, no appreciable radio-opaque stones noted Unblocking procedure: - Using catheter tip from a 22G catheter the urethra was flushed using ~12 mls LRS until a steady stream of urine was expelled from the urethra - a 3.5 french MILA urinary catheter was passed and approximately 120 mls of dark red urine was removed from the bladder - using 3-0 monocryl the urinary catheter was sutured into place E-collar placed House in medical Gabapentin 100mg/ml 1 ml PO BID x14d Monitor urinations SURGERY: Temporary waiver due to clinical status

2/19/2026

Chemistry Glucose 193 mg/dL (74-159) SDMA > 100 ug/dL Creatinine too high to read BUN > 130 mg/dL Hyperphosphatemia > 16.1 mg/dL Hypocalcemia 5.8 mg/dL Hyponatremia 146 mmol/L Hyperkalemia > 10 mmol/L Hypochloremia 111 mmol/L TP WNL ALT/ALP WNL A: Hyperglycemia- r/o stress vs. other Severe azotemia Severely impaired renal fxn based on elevation of SDMA Severe electrolyte disturbances consistent with urinary blockage Marked hyperkalemia P: Cerenia 10mg/ml 0.5 ml IV q24hr x3d Bolus 250mls LRS IV over 20 minutes Sibadoml 1.8mg/ml 0.7 ml SQ once tonight Zorbium for appropriate weight tomorrow

2/19/2026

Quiet after sedation. HR: 150 bpm at 6pm, normal sinus rhythm.

2/20/2026

Hx: FLUTD with UO S: QAR, periodically purring. Remains laying down in kennel. U-cath is patent. IV cath patent. O: EENT: Eyes clear, no nasal or ocular discharge noted H/L: normal sinus rhythm (180bpm), no murmur noted, CRT < 2, Lungs clear, eupneic ABD: Soft, mildly painful, no masses palpated. U/G: Externally WNL, u-cath in place, intact male CNS: Mentation quiet but appropriate A: FLUTD with UO Bradycardia/arrhythmia- resolved Intact male Prognosis: Guarded P: Flush u-cath and placed collection system to keep clean throughout the day CWCT Possibly remove u-cath in 3 days Repeat chemistry 2/22

2/20/2026

100 mls urine production in collection system throughout the day. Hematuria. IV catheter does not appear patent. Replacing and placed in LFL.

2/21/2026

Hx: FLUTD with UO S: QAR. IV cath patent. Did not eat overnight. U-cath patent. O: EENT: Eyes clear, no nasal or ocular discharge noted H/L: normal sinus rhythm, no murmur noted, CRT < 2, Lungs clear, eupneic ABD: Soft, non-painful, no masses palpated. U/G: Externally WNL, u-cath in place, intact male CNS: Mentation quiet but appropriate A: FLUTD with UO Anorexia Intact male P: Flushed u-cath and placed collection system to keep clean throughout the day D/c gabapentin as pet is not eating and when attempting to put into mouth begins hypersalivating

2/21/2026

Urinalysis USG 1.015 pH 7.0 Protein 3+ Glucose trace Ketones neg Blood 3+ Urobilinogen normal WBC 30-50 RBC > 100/ HPF Bacteria none Epithelial 2+ Mucus none Casts/crystals none A: Inappropriate urine concentration Proteinuria Hematuria Pyuria P: Culture pending CWCT

2/22/2026

Issue List: - FLUTD with UO - marked azotemia/uremia - anorexia depressed, DH pink; bloody urine on towel in cage EENT: no nasal or ocular discharge noted; e-collar in place H/L: eupneic PLN: WNL ABD: tense; non-palpable bladder U/G: MI; urinary catheter in place MSI: lying quietly, normal hair coat CNS: Mentation quiet - no signs of neurologic abnormalities A) FLUTD with UO marked azotemia marked dehydration poor prognosis P) Fluids- 30 ml/hr for 3 hrs then re-asssess repeat CHEM: BG- 269 mg/dl r/o stress elevated SDMA 20 microg/dl (normal 14) elevated BUN- 92 mg/dl (N-36) elevated creatinine- 2.5 mg/dl (N-2.4) hyperphosphatemia r/o post-renal vs renal vs renal vs combination levels have improved post un-blocking but still guarded In House Ultrasound- no free fluids noted at time of presentation leaving urinary catheter in place as cat's FLUTD signs are still active

2/22/2026

Urine culture: no growth.

2/23/2026

Pet ate some tuna this morning. UG: small bladder, bloody urine dripping through u-cath. A: 4th day of u-cat hematuria appetite improving prognosis: poor Plan Removed IVC LRS 150 mls SQ sid x 3 days Gabapentin 100mg/ml 1 ml po in food bid x 14d Remove u-cath tomorrow.

2/24/2026

Pet ate some tuna overnight. Bloody urine on bedding. Pet did not eat gabapentin this am. ABD/UG: Small bladder. Blood urine dripping from ucath. prognosis: poor Plan removed urinary catheter LRS 150 mls SQ Simbadol 1.8mg/ml 0.6 ml SQ sid x 2 days c/w gabapentin Monitor urinations Advise emergency placement for monitoring in a veterinary clinic

2/25/2026

SO: FLUTD with obstruction. Urinary catheter removed yesterday. Monitoring for urination BAR, tense and curled up inside of hidey box. eent: eyes clear, no ocular or nasal dc apparent h/l: eupneic, no coughing or sneezing appreciated msi: ambulatory x4 abd: abd palp moderate sized bladder, firm on palpation neuro: mentation alert and appropriate A: FLUTD P: suspect obstructed again, but will monitor for an attempt at urination after handling as FAS also high

2/25/2026

Not attempting to urinate, bladder firm and non compressible Sedated to replace urinary catheter using 0.1ml dexmedetomidine 500mcg/ml 0.05ml ketamine 100mg/ml and 0.1ml butorphanol 10mg/ml IM Placed in sternal recumbency shave at sacrococcygeal joint and prepared area with alcohol and chlorhexidine scrub instilled 0.5ml lidocaine into sacrococcygeal space to provide local anesthesia to perineal area Placed 3.5 Fr red rubber catheter Confirmed placement of urinary catheter with lateral radiograph, fixed in place with white tape and stay sutures on base of prepuce and drained approximately 120ml red colored urine, last 10ml very dark red Placed cephalic IV, start LRS @20ml/hr Post sedation T 98.2 F 0.1ml antisedan IM provided heat support

2/25/2026

Behaving nauseated around food Starting 0.45ml cerenia IV SID x3d 0.25ml vitamin B12 1000mcg/ml sc once

2/26/2026

SO: FLUTD with second obstruction. Urinary catheter replaced yesterday. BAR, possibly ate a small amount of wet food overnight. Urinary catheter flushed and produced small amount of pink urine. 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: FLUTD with obstruction P: started eating some fancy feast wet food with encouragement today Zorbium for weight rechecking CBC/chem

2/26/2026

Later in day Temp 105.1 0.45ml convenia sc continue IV fluids 0.4ml robenacoxib sc once