MANNY – A1110713
Safe - 5-2-2017 Manhattan
SAFE 5/2/17 Super sweet Little kitten boy Manny has Multiple fractures to right pelvis and needs your help @MACC
Manhattan Center
A1110713 – Manny 6m Male Tuxedo DSH
Stray:5/01/2017
INTIAL EXAM
DVM Intake Exam
Estimated age: 6 months
Microchip noted on Intake? neg
History : brought in as a stray, unable to use hind limbs well
Subjective: BAR
Observed Behavior – sweet, allows handling, purring
Evidence of Cruelty seen –
Evidence of Trauma seen – severe paraparesis
Objective
BCS 4/9
EENT: Eyes clear, ears clean, no nasal discharge noted
Oral Exam: mm pk, tacky; CRT <2 sec; deciduous canines present
PLN: No enlargements noted
H/L: purring on auscultation
ABD: Non painful, no masses palpated
U/G:male intact
MSI:
urine staining on abdomen
paraparesis-voluntary movement noted in RH but not left hind
bilateral grade II MPL
mild crepitus on palpation of dorsal pelvis
CNS:
paraparesis-no voluntary motor in LH
poss deep pain neg in LH
absent CP in hindlimbs bilaterally
absent tail tone and decreased to absent anal tone
Rectal: dec to absent tone
Assessment
paraparesis-suspect back injury, r/o IVDD vs pelvic/vertebral fracture vs other
bilateral MPL-r/o traumatic vs congenital
Plan
buprenex
0.4 ml dex SP
spinal radiographs
Prognosis: guarded to poor; if tail/anal tone does not return or there is evidence of severe pelvic/spinal fracture on rads, then rec’d EHR
SURGERY: temp waiver due to neurologic dz
Re Exam:
Hx: Came in yesterday, no hx given. Crepitus palpated in dorsal pelvis, paraparesis, urine staining on abdomen, no tail tone, decreased anal tone, bilateral MPLs
S: Meows, purring, moves around kennel on own (drags hind limbs)
O: BAR-H, BCS 4.5/9, MMs pink and moist
EENT: No discharge OU, AU, nose. Clean small adult teeth.
PLNs: Not enlarged.
H/L: NSR, NMA. Eupnic, quiet lung sounds.
Abd: Soft, no pain on palpation, no masses palpated. Bladder semifirm – easily expressed.
M/S/I: Minimal motor activity or tone in hind legs. Litter and urine on hind legs. Meows and struggles when hind legs are moved around too much. Erythema visible on skin of inguinal region and around prepuce.
UG: Male intact, testicles soft and symmetrical. Easily expressed bladder, urine is dark red-orange.
Sedated with 0.15 ml buprenorphine and 0.15 ml Dexdomitor IM for pelvic rads. Displaced fracture of right ileum – multiple pieces, right acetabulum is crushed, significant collapse of the pelvic canal. Possible pubic and ischial fractures as well, but difficult to be sure due to stool in the colon that’s overlapping the pelvis, and open growth plates.
While sedated, MPLs palpated – grade 2/4 today.
A: Multiple fractures to right pelvis, does not appear to be able to urinate or defecate at the moment. 2. Hematuria – possible trauma to urethra (vs. bladder).
3. Medial patellar luxation – R/O congenital vs. traumatic
Short-term prognosis: Poor. If pt regains anal tone and ability to urinate and defecate, pt may have long-term difficulty defecating due to collapse of pelvic canal. Will need right FHO.
P:
1. Switch to Simbadol 0.3 ml SQ SID x10 days
2. Miralax 1/4 tsp in water BID x10 days
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View all entries in: Safe Cats 2017-05