11/26/2019

[DVM Intake] DVM Intake Exam Estimated age: 2 years Microchip noted on Intake? No History: Stray Subjective: BARH. No csvd Observed Behavior - Very hyper, tugging on leash, and little nervous energy, but friendly and allows handling Evidence of Cruelty seen - no Evidence of Trauma seen - no Objective P = wnl R = wnl BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: clean dentition PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: MI with two descended testicles, no discharge MSI: Ambulatory x 4, skin free of parasites, diffuse hypotrichosis noted CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: normal externally Assessment Hypotrichosis- Suspect underlying allergies Prognosis: good Plan: Recommend dermatology workup with placement SURGERY: Okay for surgery Temporary waiver due to Permanent waiver due to

11/29/2019

Noted to have hematochezia S: BAR. No csv noted. Liquid bloody diarrhea noted in cage and on animal Eyes: Grossly appropriate OU. Ears: Unremarkable AU. Nasal Cavity: No nasal discharge. Lungs: Eupneic Musculoskeletal: Ambulatory x 4 with no appreciable lameness. BCS = 5/9 Neuro: Appropriate mentation. Rectal: Not performed. Externally normal. Assessment: hematochezia Plan: start metronidazole 10 mg/kg PO BID x7d start panacur 50 mg/kg PO SID x5d reassess in 7 days

12/1/2019

Progress exam History : Intake 11/26/19-dermatitis 11/29-started on metronidazole and panacur for diarrhea. Subjective: BAR. Cage exam. Hematochezia still noted on rounds board. Behavior team has been giving variety of enrichment, will dc Objective EENT: Eyes clear, no nasal or ocular discharge noted H/L: Normal RR/RE, eupneic MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment: Dermtatitis Hematochezia r/o stress vs parasites vs other Prognosis: Good Plan: CTM while at BACC Continue metronidazole 15mg/kg PO BID until 12/6 Continue panacur 50# dose in food SID until 12/3 Start proviable 1 cap PO SID until 12/6 Fecal scheduled

12/2/2019

Progress exam History : Intake 11/26/19-dermatitis 11/29-started on metronidazole and panacur for diarrhea. 12/1-start on proviable to diarrhea Subjective: BARH. No csv but is still having explosive diarrhea. No more blood in stool. Objective EENT: Eyes clear, no nasal or ocular discharge noted ORAL: Clean adult dentition, pink and moist mm PLN: nsf H/L: NMA, RR, Lungs CE ABD: Mildly tense on abdominal palpation, no masses palpated MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat, very raw scrotum and anus UG: MI, 2 testicles descended, see above for scrotal ulceration CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment: Hematochezia r/o stress vs parasites vs other Scrotal and anal ulceration Prognosis: Good Plan: CTM while at BACC Continue metronidazole 15mg/kg PO BID until 12/6 Continue panacur 50# dose in food SID until 12/3 Continue proviable 1 cap PO SID until 12/6 Fecal scheduled pending collection Gave cerenia 1mg/kg SQ Gave rimadyl 4.4mg/kg SQ once, start 4.4mg/kg PO SID x3d until 12/5 unless hematochezia returns Gave B12 2ml SQ, ok to repeat q 1week for 4-6 weeks if indicated Unable to apply SSD-area too sensitive to touch CBC-mild leukocytosis 18.64 (5.05-16.76), neutrophilia 13.46 (2.95-11.64), monocytosis 3.23 (0.16-1.12) Chem-nsf PCV/TS 45%/6.6

12/3/2019

[Spay/Neuter Waiver - Medical Condition] Your newly adopted animal is currently temporarily waived from the spay/neuter requirements of the City of NY by the staff veterinarians due to diarrhea. Follow up care at your regular veterinarian is recommended to ensure continued treatment. Your veterinarian will advise you if surgical sterilization is appropriate.

12/3/2019

Progress exam History : Intake 11/26/19-dermatitis 11/29-started on metronidazole and panacur for diarrhea. 12/1-start on proviable to diarrhea 12/2-gave SQ rimadyl once for ulcerated scrotum. Gave cerenia and B12 once. CBC-mild leukocytosis 18.64 (5.05-16.76), neutrophilia 13.46 (2.95-11.64), monocytosis 3.23 (0.16-1.12) Chem-nsf PCV/TS 45%/6.6 Subjective: BARH. No csv but is still having explosive hematochezia FS 7/7. Great appetite. No csv. Objective EENT: Eyes clear, no nasal or ocular discharge noted ORAL: Clean adult dentition, pink and moist mm PLN: nsf H/L: NMA, RR, Lungs CE ABD: SNP, NMP MSI: skin free of parasites, no masses noted, healthy hair coat, very raw and ulcerated scrotum and anus UG: MI, 2 testicles descended CNS: Sedated Assessment: Hematochezia r/o ileus vs stress vs parasites vs other Scrotal and anal ulceration Prognosis: Good to fair Plan: CTM while at BACC Continue metronidazole 15mg/kg PO BID until 12/6 Last day of panacur Continue proviable 1 cap PO SID until 12/6 Fecal -no ova seen Gave cerenia 1mg/kg SQ Gave LRS 500ml SQ Gave metoclopramide 0.5mg/kg SQ once, start PO SID x7d until 12/10 Dc rimadyl +/- repeat B12 2ml SQ 12/9 Washed off anus and scrotum-applied SSD Rec AUS +/- scope If still having hematochezia on recheck, consider rectal, parvocite (although unlikely given age and clinical presentaiton) Sedated with dexdomitor 10mcg/kg + butorphanol 0.2mg/kg SQ, full reversal with antisedan AXR-small amount of gas in SI-uniform in size consistent with ileus, feces in colon, stomach is gas filled and empty, no other sig findings

12/4/2019

Progress exam History : Intake 11/26/19-dermatitis 11/29-started on metronidazole and panacur for diarrhea. 12/1-start on proviable to diarrhea 12/2-gave SQ rimadyl once for ulcerated scrotum. Gave cerenia and B12 once. CBC-mild leukocytosis 18.64 (5.05-16.76), neutrophilia 13.46 (2.95-11.64), monocytosis 3.23 (0.16-1.12) Chem-nsf PCV/TS 45%/6.6 12/3-gave SQF, cerenia, started on metoclopramide Fecal-no ova seen AXR-small amount of gas in SI-uniform in size consistent with ileus, feces in colon, stomach is gas filled and empty, no other sig findings Subjective: BAR. Bloody diarrhea noted on rounds board. Serous nasal dc and sneezing. Objective EENT: Eyes clear, serous nasal dc H/L: RR, RE, sneezing MSI: ambulatory x4, GHC CNS: A&A Assessment: Hematochezia r/o ileus vs stress vs parasites vs other Scrotal and anal ulceration CIRDC Prognosis: Good to fair Plan: CTM while at BACC Continue metronidazole 15mg/kg PO BID until 12/6 Continue proviable 1 cap PO SID until 12/6 Continue metoclopramide 0.5mg/kg PO SID until 12/10 +/- repeat B12 2ml SQ 12/9 Rec AUS +/- scope If still having hematochezia on recheck, consider rectal, parvocite (although unlikely given age and clinical presentation) Move to iso Start baytril 10mg/kg PO SID x14d until 12/18 (consider starting doxycycline if no improvement but elected just baytril due to diarrhea)

12/9/2019

Progress exam History : Intake 11/26/19-dermatitis 11/29-started on metronidazole and panacur for diarrhea. 12/1-start on proviable to diarrhea 12/2-gave SQ rimadyl once for ulcerated scrotum. Gave cerenia and B12 once. CBC-mild leukocytosis 18.64 (5.05-16.76), neutrophilia 13.46 (2.95-11.64), monocytosis 3.23 (0.16-1.12) Chem-nsf PCV/TS 45%/6.6 12/3-gave SQF, cerenia, started on metoclopramide Fecal-no ova seen AXR-small amount of gas in SI-uniform in size consistent with ileus, feces in colon, stomach is gas filled and empty, no other sig findings 12/4-started on baytril for CIRDC Subjective: BAR. Cage exam. FS 6/7 brown diarrhea noted in cage. No more blood noted in feces. Sneezing. Great appetite. Objective EENT: Eyes clear, serous nasal dc H/L: RR, RE, sneezing MSI: ambulatory x4, GHC CNS: A&A Assessment: Hematochezia r/o ileus vs stress vs parasites vs other condition Scrotal and anal ulceration CIRDC Prognosis: Good to fair Plan: CTM while at BACC Ok to dc metronidazole (no significant improvement) Continue proviable 1 cap PO SID indefinitely Continue metoclopramide 0.5mg/kg PO SID until 12/10 B12 2ml SQ once a week q 4-6 weeks (this is the second injection) +/- repeat 12/16 Rec AUS +/- scope Rec GI diet with placement Iso Continue baytril 10mg/kg PO SID until 12/18 Start trazodone 5mg/kg PO BID for shelter anxiety

12/11/2019

Progress exam History : Intake 11/26/19-dermatitis 11/29-started on metronidazole and panacur for diarrhea. 12/1-start on proviable to diarrhea 12/2-gave SQ rimadyl once for ulcerated scrotum. Gave cerenia and B12 once. CBC-mild leukocytosis 18.64 (5.05-16.76), neutrophilia 13.46 (2.95-11.64), monocytosis 3.23 (0.16-1.12) Chem-nsf PCV/TS 45%/6.6 12/3-gave SQF, cerenia, started on metoclopramide Fecal-no ova seen AXR-small amount of gas in SI-uniform in size consistent with ileus, feces in colon, stomach is gas filled and empty, no other sig findings 12/4-started on baytril for CIRDC 12/9- started trazodone S: BAR. Eating well. Mild sneezing. No cvd. No mention of having diarrhea or hematochezia on white board Eyes: Grossly appropriate OU. Ears: Unremarkable AU. Nasal Cavity: mild serous nasal discharge. Lungs: Eupneic Musculoskeletal: Ambulatory x 4 with no appreciable lameness. BCS = 5/9 Neuro: Appropriate mentation. Assessment: Hematochezia (resolving) r/o ileus vs stress vs parasites vs other condition Scrotal and anal ulceration CIRDC Prognosis: Good to fair Plan: CTM while at BACC Continue proviable 1 cap PO SID indefinitely Continue metoclopramide 0.5mg/kg PO SID until 12/10 B12 2ml SQ once a week q 4-6 weeks+/- repeat 12/16 Rec IM consult (AUS +/- scope, diet alteration) if clinical signs reoccur Continue baytril 10mg/kg PO SID until 12/18 Continue trazodone 5mg/kg PO BID for shelter anxiety Recheck CIRDC d10

12/14/2019

Progress exam History : Intake 11/26/19-dermatitis 11/29-started on metronidazole and panacur for diarrhea. 12/1-start on proviable to diarrhea 12/2-gave SQ rimadyl once for ulcerated scrotum. Gave cerenia and B12 once. CBC-mild leukocytosis 18.64 (5.05-16.76), neutrophilia 13.46 (2.95-11.64), monocytosis 3.23 (0.16-1.12) Chem-nsf PCV/TS 45%/6.6 12/3-gave SQF, cerenia, started on metoclopramide Fecal-no ova seen AXR-small amount of gas in SI-uniform in size consistent with ileus, feces in colon, stomach is gas filled and empty, no other sig findings 12/4-started on baytril for CIRDC 12/9-started on trazodone, gave B12 (second injection) Subjective: BAR. No csvd. ACS reported diarrhea has resolved! Great appetite. CIRDC resolved. Objective EENT: Eyes clear, no nasal or ocular dc H/L: RR, RE, no cs MSI: ambulatory x4, GHC CNS: A&A Assessment: Apparently healthy Hx Hematochezia (resolved) r/o ileus vs stress vs parasites vs other condition Prognosis: Good to fair Plan: CTM while at BACC-if hematochezia returns rec scope +/- AUS +/- IM consult Continue i/d diet Continue proviable 1 cap PO SID indefinitely Ok to move out of iso Continue baytril 10mg/kg PO SID until 12/18 Continue trazodone 5mg/kg PO BID for shelter anxiety

Upon intake, Nas was friendly with intake staff. He pulls very hard on the leash. He was very distracted by everything going on around him. He tolerated all handling including collaring and leashing. Counselors took him outside for a quick walk and potty break and he urinated once he got outside.