GENE – A1105850
Safe - 5-26-2017 Brooklyn
GENE IS A KITTEN WHO HAS MULTIPLE BURNS AND NEEDS MEDICAL ATTENTION ASAP!
GENE – A1105850
MALE, GRAY TABBY / BLK TABBY, DOMESTIC SH MIX,6 mos
STRAY – STRAY WAIT, NO HOLD Reason STRAY
Intake condition UNSPECIFIE Intake Date 03/10/2017, From NY 11207, DueOut Date 03/13/2017,
3/10 exam DVM Intake Exam Findings Subjective burns (thermal vs chemical) covering muzzle, eyelids, all four pads, scrotum, tail tip ear tips. burns appear at least 24-48 hours old–skin sloughing off. No odor. OD lid affected–may have permanent defect. all four canines broken off wounds are consistent with (but not daignostic for) being trapped in a dryer or similar machine Observed Behavior – allows all handling, quiet Evidence of Cruelty seen – yes Evidence of Trauma seen – yes Objective BCS 5/9 EENT: Eyes clear, ears clean, no nasal discharge noted Oral Exam: all four canines are broken PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: intact male–scrotum burned MSI: severe wound to four paw pads CNS: qar Assessment burns, broken teeth Plan: gave 0.25 simbadol sq, 0.5ml clavamox po soaked feet in chlorhex, removed scabs from feet and face prognosis is good. wounds are wide ranging but largely superficial. dental needed at some point
3/11 exam Recheck wounds S/O: BARH. Active, attention seeking, allows all handling. Eating with excellent appetite BCS 4/9 EENT: Pink mm, teeth clean, all canine teeth broken, no nasal discharge, difficulty opening right eye, appears visual in both eyes INTEG: Wounds over face, paws – healing, significant inflammation at perianal/anal region, with mild prolapse of tissue, minimal anal tone A: Superficial, but significant, wounds over face, paws and perianal region, most concerning area at this time is the anal region due to lack of tone and mild prolapse P: Adding otibiotic to anal region q12 x 5 days (for abx and steroid). Likely to improve with medical management but may require surgical care.
3/12 exam Recheck exam. S/O: QARH. Eating/drinking well, mod. amount of urine on towel, soft formed feces in cage. ORAL: All 4 canine teeth fractured, no obvious pulp exposure, teeth are not discolored. EENT: No nasal discharge or sneezing. H/L: HR=220, RR=32/purring. Lungs clear, no murmurs/arrhythmias. ABD/UG: Abd palpation WNL. Mod. scrotal swelling with crusted material on surface. MS: Voluntary motor activity x 4 but reluctant to walk due to paw injuries. INTEG: Tips of pinnae dried and curled in. Periocular skin dried and sloughing off OU. Necrotic skin over rostral muzzule with areas of slough, exposed tissue pink and moist, mild swelling. Ventrum of all four feet – unable to visualize skin or tissue due to large amiunt of dried material (suspect feces + dried discharge) on paws. Paws are mildly to modreately swollen and painful. Mod. perianal moisture and swelling, with feces accumulated on perianal skin. A: Significant skin injuries on face and paws, perineum. Painful. P: All areas need debridement with sedation. Cat fed this AM, will sedate later in PM to debride and clean wounds. May need bandaging for comfort as well as to keep feet clean. Fair prognosis.
3/12 exam Administered Telazol 0.05 ml IM. Cleaned paws with dilute chlorhexidene to remove crusted debris – most of which was dried feces. After cleaning, flushed with sterile LRS. Toepads on all feet are macerated, with mod. interdigital erythema and swelling. majority of toepads are peeling away from deeper tissues. Bluntly debrided with gauze to remove loose tissue; more adherent skin pad and skin left in place. Flushed again with LRS, and placed wet-to-dry bandages on all feet. Cleaned perineum with warm water to remove soft feces/diarrhea. Perianal area is ulcerated, but anal tone appears intact. Cleaned face with warm water, unable to remove necrotic skin around OD as it was very adherent and cat was recovering from sedation. Applied artificial tears ointment OU. Plan: Bandage change with sedation tomorrow. Will need daily until healthy granulation tissue is present, then can switch to non-adherent dressing with less frequent changes. Stop oral antibiotics as this may be contibuting to diarrhea. Give Convenia 80 mg/ml 0.2 ml SQ.
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