PARROTFISH – A1076542
Gone - 6-7-2016 Manhattan
PARROTFISH – A1076542
7w Female Black DSH
Presented suspect trauma – fall?
BAR, vocal. Amb x 4 – no palpable long bone fractures, crepitus.
Significant swelling of left side of face. OS is moderately proptosed with apparent hyphema and conjunctival hemorrhage. No apparent trauma at oral cavity
Epistaxis at left nare
H/L clear. Eupneic. HR >200
Abd soft, nmp
A: 1.5 mo F DSH
Head trauma with ocular injuries, epistaxis – unknown origin
Stable now, extent of injuries unknown
P: Gave IM Buprenex (0.5 mg/ml) 0.04 ml at 6.30pm – patient showed good response to pain control
Transfer to MACC for overnight monitoring, further tx/dx – spoke with mgmt for arrangements
Re-examine tomorrow, monitor progress
Continue buprenex TID
Reco New Hope
Relatively stable now, if no worsening of status and able to maintain stability, will possibly need enucleation. Consider ab’s to avoid abscess of hemorrhagic globe
Supportive care if NE
Hx: Head trauma
S: Mews when touched, prefers to lie down on R side and twist to R. Allows all handling. Moves slowly.
O: QAR, weak, mildly decreased skin turgor, estimated 8-10% dehydrated, BCS 4/9, pink and tacky
EENT: OS periocular tissues are severely swollen and bruised (conjunctiva are dark red). Lids are almost closed, pt resists palpation of region. Third eyelid is fully prolapsed and bruised (dark red). Globe does not appear to be proptosed but it is difficult to be sure. Mild erythema and abrasion at left side of muzzle. Clean ears. Clean teeth.
H/L: NSR, NMA. Eupnic, quiet lung sounds.
Abd: Soft, no pain on palpation, no masses palpated
M/S/I: Pt doesn’t walk – lies down and falls to R side. Right front leg is wet (water spilled in cage). No fractures or swelling of long bones is palpated.
A: Kitten with head trauma
- OS severe swelling of periocular tissues. The globe does not appear to be proptosed.
- Weak overall
- Falls and rolls to right – R/O central vs. peripheral vestibular disease vs. musculoskeletal problem on R side
Short-term prognosis: Fair
- Continue buprenorphine – BID only (cannot reach TID in shelter setting)
- Artificial tears ointment OS BID
- Monitor OS for worsening, determine if eye is truly proptosed
- LRS 25 ml SQ SID x4 days
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View all entries in: Gone Cats 2016-06