WAGNER – A1114869
Gone - 6-12-2017 Manhattan
GONE 6/12/17 **FELV POSITIVE** WAGNER is not feeling well and tested positive for FELV. He needs further medical care and has a URI and has a painful mouth and may have other issues. Needs immediate rescue.
WAGNER – A1114869
MALE, GRAY TABBY, DOMESTIC SH MIX,5 yrs
STRAY – STRAYAVAI, NO HOLD Reason STRAY
Intake condition EXAM REQ Intake Date 06/10/2017, From NY 11218, DueOut Date 06/13/2017,
Medical Behavior Evaluation BLUE
Medical Summary DVM Intake Exam Estimated age: 5yrs Microchip noted on Intake? none History : stray Subjective: Observed Behavior -allows handling with towel Evidence of Cruelty seen – no Evidence of Trauma seen – no Objective P = 150 R = 48 BCS 4/9 EENT: mild dried d/c from eyes, OS: abN shaped pupil, with some reddish infitrates in the ventromedial portion of the anterior chamber. Anterior chamber also appears shifted and shallow, PLRs intact OU. Moderate purulent nasal d/c from nares Oral Exam: purulent d/c from mouth. Edges of tongue- ulcerated. Moderate gingivitis PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: MI, both testicles descended MSI: Ambulatory x 4, skin free of parasites, no masses noted, slow skin tent, no palpable abN around orbit of OS CNS: mentation appropriate – no signs of neurologic abnormalities Assessment MI FeLV positive on snap dehydrated approx 5-7% URI OS: r/o infectious, inflammatory, prev trauma with possible lens luxation, neoplasia, other underweight after cbc/chem/t4 in house: chronic renal failure vs prerenal suspected (UA would be needed to confirm low USG), mild anemia, hyperphosphatemia, neutrophilia with suspected bands, mild low platelets Plan IV fluids LRS 8ml/hr; after getting CBC/chem results increased to 10ml/hr cerenia 10mg/ml: 0.3ml SQ SID x2 for inflammation (first dose given 12noon) buprenorphine 0.3mg/ml: 0.2ml SQ BID x3 (since mouth is painful, avoiding placing things orally) (first dose given 12 noon) B-12vit 0.25ml SQ SID x2 (first dose given 12noon) pet tinic 0.5ml PO SID x10days check app cbc/chem in house long term rec ophtho consultation __________________________________ Update via 1033 Recheck CBC/Chem after 48 hours UA if possible Prognosis: open, pending how p responds SURGERY: Temporary waiver due to URI, underweight
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