KLEIN – 21387
Safe - 3-4-2018 Manhattan
***SAFE 03/04/18*** KLEIN NEEDS FOLLOW UP VET CARE AND NEEDS A RESCUE ANGEL TONIGHT!
Poor Klein has got some medical issues going on. He has an oral abscess, a heart murmur, and acute kidney disease all which need follow up vet care. Fostering is a way to help KLEIN get the help he needs and the rescue handles the vet cost. KLEIN needs to exit the shelter NOW and YOU MUST RESERVE HIM BY NOON!!
Manhattan Center
Hello, my name is Klein. My animal id is #21387. I am a desexed male gray tabby cat at the Manhattan Animal Care Center. The shelter thinks I am about 5 years old. – P
I came into the shelter as a stray on 22-Feb-2018.
Klein is at risk for medical reasons. Klein has an oral abscess, acute kidney disease (grade 3) and a Grade 3/5 heart murmur, all of which will require further veterinary assessment. Behaviorally, we suggest that Klein would be best suited to an experienced cat home.
My medical notes are…
Weight: 10.5875 lbs
22/02/2018
[DVM Intake] DVM Intake Exam Estimated age:5-7 y Microchip noted on Intake?n Microchip Number (If Applicable): History : bleeding from mouth Subjective:left maxillary area swollen, painful. sedated 0.1 telazol IM. Observed Behavior -growling. would not allow oral exam awake Evidence of Cruelty seen -n Evidence of Trauma seen -n Objective T = P =200 R =wnl BCS 6/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam:maxillary abscess: caseus/bloody materal expelled with pressure. probed with qtip. rest of mouth wnl PLN: No enlargements noted H/L: NSR, 3/6 heart murmur Lungs clear, eupnic ABD: Non painful, no masses palpated U/G:neutered male MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate – no signs of neurologic abnormalities Assessment: oral abscess, rule out secondary to SCC, other oral neoplasia vs tooth root abscess Prognosis:fair Plan:radiographs. Ab’s once awake. if abscess does not resolve rapidly, prognosis becomes poor
22/02/2018
S: While under sedation from intake (telazol), we took V.D and Lateral x-rays of the skull. The wound on the left cheek was further evaluated and found to be 2 cm deep pocket into the masseter muscle of the left check. There was no evidence of a tooth abscess and or neoplasia. Purulent material was found in the pocket. The wound was flushed with 50 cc of chlorohexidine solution 2% while the patient was a dorsal recumbency. Blood work – severe azotemia and mild anemia, inflammatory response (refer to summary) V/D and Lateral Skull X-rays Unremarkable – soft tissue swelling could be observed along the left mandible. Assessment: Oral/Cheek abscess, acute vs chronic kidney disease (severe azotemia, mild anemia, mild leukocyosis, and hyper-phosphatemia) Plan: Place on IV fluids 20ml/hr for 24 hrs and reduce to 15ml/hr thereafter Simbadol 0.24 mg/kg/0.6 ml SQ SID for 3 days – Onsior 2mg/kg/0.5ml SQ SID ONE DOSE ONLY (do not give any further onsior until kidney values resolve) Unisyn IV 30 mg/kg – 150 mg IV BID for 7 days – SEND HOME WITH SIMPLICEF 25 MG PO SID FOR 10 DAYS
23/02/2018
severe azotemia 2/22/18 Cre 12.6 BUn > 16.1 TP 9.4, Glob 6.2 BAR mild dehydration Extensive muscle wasting Appetite – eating when prompted EENT: limited oral exam due to temperment- L sided facial swelling with hemorrhage Cv/L : RR 30 HR 150 Grade 3/5 heart murmur Assessment: Oral/Cheek abscess, pre versus post renal azotemia acute vs chronic kidney disease (stage 4) (severe azotemia, mild anemia, mild leukocyosis, and hyper-phosphatemia) Grade 3/5 heart murmur r/o HCM, endocarditis, secondary to anemia Plan: IV fluids reduce to 15ml/hr. Monito resp Simbadol 0.24 mg/kg/0.6 ml SQ SID Unisyn IV 30 mg/kg – 150 mg IV BID for 7 days – Recheck renal values after 3 day of fluids SEND HOME WITH SIMPLICEF 25 MG PO SID FOR 10 DAYS
24/02/2018
S/O: QAR, eating and drinking, purulent bloody discharge draining from check abscess Repeated blood work – mild improvement in kidney values otherwise unchanged A: Severe azotemia, oral abscess P: Sedated with – Ketamine (0.4 ml), Butrophanol (0.5ml) and dexmedetomidine (0.9 ml) – revered with antisedan (0.9 ml) – all IM Cleaned and Flushed wound with 50 ml of dilute chlorhexidine solution Debrided necrotic tissues around wound 1) Continue on fluids and antibiotic therapy 2) Give Cerenia 1mg/kg SID for 4 days IV 3) Collect Urine and perform USG 4) Place on a kidney care diet (e.g. KD. Urinary Care, etc) Prognosis: Guarded considering little to no improvement in kidney values post IV fluids
24/02/2018
CBC HCT – 19.8%, Neutrophilia (27.3), Elevated creatine (12.8, elevated BUN >130, elephated Phsop >16.1)
25/02/2018
S/O – BAR, has a good appetite, can be fractious to examine Oral abscess still draining blood/discharge Urinalysis and USG: 1020, + 3 Leukocytes otherwise WNL Assessment: 1) Oral/Cheek abscess, 2) Acute (pre-renal/dehydration) vs chronic kidney disease (grade 3) considering kidneys still concentrating urine (1020) 3) Grade 3/5 heart murmur r/o HCM, endocarditis, secondary to anemia Sedated with 0.2 ml Dexmeditomide to place extension back on catheter Plan – Monitor azotemia by repeating blood work Continue on current tx plan Raise fluid therapy to 2 x maintenance Recommend phosphate binders if phosphate continually elevate
22/02/2018
Patient arrived from intake sedated with 0.1ml of Telazol IM @ 1:15PM into Veterinary Services area. Temperature at 99 degrees (rectal). Three view rads of the maxilla (skull) were taken and reviewed by DVM. A CBC-CHEM was performed and reviewed by DVM, results stored in vet documents.. 0.5mls of Onsior 20mg/ml and 0.6mls of Simbadol 1.8mg/ml were administered SQ @ 1:50pm. Abscess was flushed by DVM using dilute Chlorhexidine solution. A 22g IVC was placed on the RFL and IVF started @ 15mls/hr. Patient was placed in housing for recovery with heat support due to cold extremities.
22/02/2018
Patient’s catheter site showing signs of swelling due to tightness of tape. Tape was cut to relieve pressure and bridged to secure. Catheter was flushed and remains patent and IVF is flowing adequately. Notes detailed on treatment board and treatment sheet to check IVC site overnight.
23/02/2018
gave 0.6cc of Simbadol 1.8mg/ml bottle number 67 at 9:25am LVT 0811
24/02/2018
gave 0.6cc of Simbadol 1.8mg/ml bottle number 67 at 8:53am LVT 0811
25/02/2018
Klein was scheduled for an AM tx of Simbadol 1.8mg/ml. Administered 0.6mL SQ at 8:25am from bottle #68. DVM 1493 1215
25/02/2018
as per dvm 1493, no need to run new chem sample at this time.
25/02/2018
Urinalysis performed by 1398
Details on my behavior are…
Behavior Condition: 3. Yellow
upon intake, klein allowed to be picked up and placed in carrier. counselor did not due much handling like collaring due to to possible injury.
Basic Information:: klein came in as a stray so behavior is unknown.
KNOWN HISTORY:: Klein was brought in as a stray so we cannot speak to his behavior in his previous home.
MEDICAL BEHAVIOR:: 2/22/18 Observed Behavior -growling. would not allow oral exam awake
ENRICHMENT NOTES:: 2/23/18 Lying down with head up on his cage bedding during the approach. Remains immobile, but when touched he slowly head rubs the assessor’s hand and allows petting along the body with no further interest.
Cage Condition:: Cage is slightly re-arranged
Reaction to assessor:: Klein lays in place and looks at the assessor with soft posture and dilated eyes.
Reaction when softly spoken to:: Klein continues to look at the assessor.
Reaction to cage door opening:: Klein remains calm and relaxed.
Reaction to touch:: Klein leans into the stroke, with some grumbling and looking around. Seems unsure.
ACTIVITY LEVEL:: Laid back
VOCAL:: Quiet
CHARACTER TYPE: : Calm,Independent
POTENTIAL CHALLENGES:: Other
Potential challenges comments:: Please note that this cat is being treated for a medical condition at the time of evaluation. It is difficult to determine at this time how the medical condition may be affecting the behavior.
BEHAVIOR DETERMINATION: : Experience
Behavior Asilomar: TM – Treatable-Manageable
RECOMMENDATIONS:: None
BEHAVIOR SUMMARY:: Klein tolerates attention and petting but may be fearful or stressed in the shelter. He may be a little more independent, and may need time to warm up to his new home. We recommend that this cat go to a home with experienced cat parents.
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View all entries in: Safe Cats 2018-03