HONEY – 22943

MANHATTAN CENTER

Honey 22943

Location: Manhattan

Intake Date: 3/15/18

Intake Type: Stray

Medical Behavior: Green

Sex: Neutered

Age: 3 years

Original Location: 11366

 

Medical:

17-Mar-2018
Tech Exam
L V T Notes: 9:29 AM

Administered 0.5mls of Onsior 20mg/ml SQ @ 9:10am.
16-Mar-2018
Progress Exam
L V T Notes: 6:15 PM

Per Dr, sedated Honey with Buprenorphine 0.15 mls (at 4:33 PM from Bottle # 5), Ketamine 0.23 mls (at 4:33 PM from Bottle # 18), and Dexmedetomidine 0.09 mls IM
Administered Onsior 20 mg/ml 0.5 mls SQ

Vet Notes: 6:14 PM

S/O – Otoscopic examination with sedation

Sedation – 0.23 ml Ketamine, 0.15 buprenorphine, 0.09ml dexmeditomidine IM

Objective

T = =
P = 220
R = WNL
BCS = 4/9

PLN: No enlargements noted
H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic
ABD: Non painful, no masses palpated
U/G: Full bladder, male neutered
MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat
CNS: Mentation appropriate – no signs of neurologic abnormalities
Rectal: normal externally

Left ear – mild flaky crusty debris – cytology negative for microorganisms

Left ear otoscopic examination

Right ear – purulent bloody discharge – + 3 Rods slide cytology.

Right Ear Otic exam examine revealed: Tympanic membrane ruptured. Moderate Hyperemia, mild stenosis. Raised fibrosis tissue/swelling of the skin rostral to the R-pinna and 1 cm round raised mass just caudal to the ear, which are likely secondary to chronic pruritis and itching of the ear – self inflicted. FNA revealed no production of fluid/discharge of these raised ‘masses/fibroma’.

The Blue-tinged masses in both ear canals are likely ceruminous cystomatosis – seem to be benign and are not causing any obstruction of the ear canal.

Assessment

1) Right Ear Otitis media
2) Right ear ruptured tympanic membrane

Prognosis: Fair

Plan 3/16/2018

– Flushed ear with otic solution
– Applied 3 drops of tresaderm in both ears
– 0.5 CC Convenia SQ
– Benign neglect for ceruminous cystomatosis
– Systemic antimicrobials – clavamox 100mg BID PO for 14 days
– ALREADY RECEIVING ONSIOR

Future Recommendations
– Recheck appointment with referring veterinarian for deep ear flushes using saline or TRIS EDTA Based cleaners such as

a) Baytril Otic® (5 mg/mL enrofloxacin with 10 mg/mL silver sulfadiazine): Use q 12 hrs; appears to be safe in the middle ear, but is off-label usage in cats.6
b) Tris EDTA solution with enrofloxacin: Combine injectable enrofloxacin with a tris EDTA flush to make a 10 mg/mL concentration (13 mL of 100 mg/mL enrofloxacin added to 118 mL bottle of tris EDTA flush).8 Flush ears q 12 hrs.
c) Diluted enrofloxacin (22.7 mg/mL): Dilute 1:2 with 4 mg/mL dexamethasone sodium phosphate and instill q 12 hrs.6
d) Ticarcillin powder for injection: Vial is reconstituted as directed, then frozen in syringes in 1 mL aliquots. A new aliquot is thawed daily and kept in refrigerator. Instill 0.2-0.3 mL q 8 hrs. ”

Reports of the bacteria associated with otitis media are largely those related to cultures taken from the middle ear in association with bulla osteotomy in the management of middle ear polyps. A compilation of this data along with the less frequent reports of bacterial otitis media document (in decreasing order of frequency) the following bacteria : Staphylococcus epidermidis, Pasturella multocida, Beta hemolytic streptococcus, Staphylococcus saprophyticus, Pseudomonas sp. , Bacteroides, Fusobacterium, Bordetella bronchiseptica4,5,8.
15-Mar-2018
DVM Intake
Vet Notes: 7:31 PM

DVM Intake Exam

Estimated age: 2-5 years old based on dentition and overall appearance
Microchip noted on Intake? Scanned negative – MC placed

History : Reported stray, no health hx offered

Subjective: Alert, meows in carrier, looks around

Observed Behavior – Allows all handling, very friendly! Purring even while I touched his painful ear.

Evidence of Cruelty seen – None

Evidence of Trauma seen – None

Objective
BAR-H, MMs pink and moist, BCS 7/9
EENT: OD 5 mm round patch of corneal opacity, mild serous discharge. OS NSF. AD alopecic, erythematous, yellow crusty discharge and blue-tinged masses protruding from the canal. There is a 2 cm round raised mass just rostral to the ear and a smaller 1 cm round raised mass just caudal to the ear – both masses are bright red, firm, with small scabs and spots of oozing blood. AS not alopecic, no erythema, no discharge – but there are several small blue-tinged masses in the canal. Wet nose, no discharge.
Oral Exam: Thick saliva, mild yellow tartar.
PLN: No enlargements noted in mandibular, prescapular or popliteal LNs
H/L: NSR, NMA, Lungs clear, eupnic
ABD: Non painful, no masses palpated
U/G: Male neutered
MSI: Ambulatory x 4, skin free of parasites, no masses noted other than those on ear, healthy hair coat
CNS: Mentation appropriate – no signs of neurologic abnormalities
Rectal: Normal externally

Fluorescein stain OD – no uptake.

Assessment:
1. Blue-tinged masses in both ear canals – likely ceruminous cystomatosis
2. Masses rostral and caudal to AD – R/O self-trauma due to pruritis vs. ceruminous cystadenomas vs. other

Prognosis: Good. These lesions are usually benign but can be very itchy and will need to be surgically removed.

Plan:
1. Onsior 20 mg/ml 0.5 ml SQ SID x7 days
2. Ear cleaning and Tresaderm tomorrow with vet oversight
3. Clavamox 1 ml PO BID x7 days
4. Consider sedated excision vs. laser ablation
Intake behavior:

Green (allowed all handling)

 

 

 

For more information on adopting from the NYC AC&C, or to find a rescue to assist, please read the following: http://urgentpodr.org/adoption-info-and-list-of-rescues.

If you are local to the Tri-State, New England, and the general Northeast United States area, and you are SERIOUS about adopting or fostering one of the animals at NYC ACC, please read our MUST READ section for instructions, or email [email protected] Our experienced volunteers will do their best to guide you through the process.

* We highly discourage everyone from trusting strangers that send them Facebook messages, offering help, for it has ended in truly tragic events.*

For more info on behavior codes and ratings, please click here: http://information.urgentpodr.org/acc-placement-status-descriptions.

For answers to Frequently Asked Questions, please see: http://information.urgentpodr.org/category/frequently-asked-questions/.

You can call (212) 788-4000 for automated instructions.

Previous | Next