PABLO – A1121395
Gone - 8-11-2017 Manhattan
DIED 8/11/17 Pablo is a gorgeous gray kitty who came in with an injured hind leg. She had a large wound on her leg and radiographs revealed a fracture. We cleaned out the wound, but she is likely going to require surgery to either repair the leg or have it amputated. Even with her injuries she has shown that she loves being pet and appreciates attention! Please let us know as soon as possible if you can take this friendly injured lady!
Poor PABLO was found limping in an alleyway. She has a femoral fracture which will need corrective surgery and has a serious wound on her abdomen which was infested with maggots, as well as maggots in other areas. The wound will need follow up medical care. Please help this 3 yr old girl – she is already spayed which tells us she was someone’s pet at one time.
MANHATTAN CENTER
PABLO – A1121395
SPAYED FEMALE, GRAY TABBY / WHITE, DOMESTIC SH,3 yrs
STRAY – STRAY WAIT, NO HOLD Reason STRAY
Intake condition EXAM REQ Intake Date 08/09/2017, From NY 10037, DueOut Date 08/12/2017,
Medical Behavior Evaluation BLUE
Medical Summary DVM Intake Exam Estimated age: approx 3 years Microchip noted on Intake? neg History : found in an alley limping; flies swarming around abdomen Subjective: QAR Observed Behavior – a little nervous/skiddish but allows handling; painful in hind end Evidence of Cruelty seen -none Evidence of Trauma seen – RH lameness/swelling; large wound in R inguinal area Objective BCS 6/9 EENT: Eyes clear, ears clean, no nasal discharge noted Oral Exam: mm pk, tacky; CRT 2 sec; mild tartar/staining PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: spayed, tattoo in L inguinal area MSI: non weight bearing LH lameness; severe soft tissue swelling and instability of femur maggot infestation noted around vulva large laceration in L inguinal area small abrasion on R side of upper lip CNS: mentation appropriate – no signs of neurologic abnormalities Rectal: anal tone present Assessment LH lameness Large wound Maggot infestation Plan sedated with hydromorphone 0.2 ml/dexdomitor 0.2 ml/ketamine 0.2 ml IM for radiographs, wound cleaning radiographs-complete comminuted mid diaphyseal fracture of femur; abdominal wall appears intact clipped/cleaned around laceration, debrided wound and flushed with copious amount of sterile sodium chloride; severe bruising and necrosis of underlying muscle with large pocket extending cranially; placed 6 simple interrupted sutures using 3-0 Monocryl in proximal aspect of wound, left distal aspect open to drain-placed sutures for her comfort but suspect that edges of wound may become necrotic; wound will likely need revision 150 ml LRS SQ convenia: 0.5 ml SQ onsior 0.5 ml SQ, continue SID x 2 days hydromorphone 2 mg/ml: 0.1 ml SQ TID until placement consider surgical stabilization of femur vs amputation Prognosis: fair to good; although wound is severe, I do suspect this is something that can heal well with time; ideally the femoral fracture would be surgically stabilized but amputation is also a very reaosonable, curative option SURGERY: spayed
Weight 10.9
Medical
DVM Intake Exam 08/09
Estimated age: approx 3 years
Microchip noted on Intake? neg
History : found in an alley limping; flies swarming around abdomen
Subjective: QAR
Observed Behavior – a little nervous/skiddish but allows handling; painful in hind end
Evidence of Cruelty seen -none
Evidence of Trauma seen – LH lameness/swelling, large laceration over L stifle
Objective
BCS 6/9
EENT: Eyes clear, ears clean, no nasal discharge noted
Oral Exam: mm pk, tacky; CRT 2 sec; mild tartar/staining
PLN: No enlargements noted
H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic
ABD: Non painful, no masses palpated
U/G: spayed, tattoo in L inguinal area
MSI:
non weight bearing LH lameness; severe soft tissue swelling and instability of femur
maggot infestation noted around vulva
large laceration over L stifle/inguinal
small abrasion on R side of upper lip
CNS: mentation appropriate – no signs of neurologic abnormalities
Rectal: anal tone present
Assessment
LH lameness
Large wound
Maggot infestation
Plan
sedated with hydromorphone 0.2 ml/dexdomitor 0.2 ml/ketamine 0.2 ml IM for radiographs, wound cleaning
radiographs-complete comminuted mid diaphyseal fracture of femur; abdominal wall appears intact
clipped/cleaned around laceration, debrided wound and flushed with copious amount of sterile sodium chloride; severe bruising and necrosis of underlying muscle with large pocket extending cranially; placed 6 simple interrupted sutures using 3-0 Monocryl in proximal aspect of wound, left distal aspect open to drain-placed sutures for her comfort but suspect that edges of wound may become necrotic; wound will likely need revision
150 ml LRS SQ
convenia: 0.5 ml SQ
onsior 0.5 ml SQ, continue SID x 2 days
hydromorphone 2 mg/ml: 0.1 ml SQ TID until placement
consider surgical stabilization of femur vs amputation
Prognosis: fair to good; although wound is severe, I do suspect this is something that can heal well with time; ideally the femoral fracture would be surgically stabilized but amputation is also a very reaosonable, curative option
SURGERY: spayed
Cage Exam 08/10
Hx: L femoral fracture, large laceration over L stifle/inguinal area; flushed and debrided yesterday, several temporary sutures placed in proximal aspect of skin wound; convenia, onsior/hydro
S/O
no appetite
QAR, slightly sedate
mm lgt pk, sl tacky
abrasion on muzzle, granulation bed forming
no nasal discharge or sneezing
OU-elevated 3rd eyelid, likely due to hydro
NWB LH lameness, some difficulty ambulating due to sedation
LH-absent withdrawal, difficult to assess due to mild sedation; significant brusing, swelling over limb, SQ emphysema; sutures intact; moderate serosanguinous discharge from wound
A
L femoral fracture
large laceration
inappetance-r/o sedation vs pain vs systemic
P
d/c hydromorphone and start simbadol this afternoon
add LRS 150 ml SQ SID x 3 days
cerenia 0.5 ml SQ SID x 3 days
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