HUNTER – 22894
Safe - 3-20-2018 Manhattan Rescue: Feline Rescue of SI Please honor your pledges: http://felinerescueofstatenisland.org/donation/
SAFE 3/20/18 **NEEDS VET CARE** Sweet HUNTER was brought to the shelter by his owner. He is 6 yrs old and already neutered and was diagnosed with chronic kidney disease by owner’s vet. He was brought in with all his meds. HUNTER also has other issues such as a heart murmur, dental disease and some skin issues. He is friendly and was purring at intake. Please offer to foster or adopt this sweet kitty. Fostering will get him the immediate care he needs.
MANHATTAN CENTER
Hunter 22894
Location: Manhattan
Intake Date: 3/15/18
Intake Type: Owner Surrender
Medical Behavior: Green
Sex: Neutered
Age: 6 years
Original Location: 10467
DVM Intake Exam
Estimated age: Reported to be 6 years old
Microchip noted on Intake? Scanned negative
History : Diagnosed with chronic kidney disease in March 2017. He currently takes:
Aphogel 64mg 1.0 ml PO q12
Benazapril 5mg 1/4 tablet PO q24
Previous owner also stated that he needs fluids.
Subjective: Alert, purring, walks around
Observed Behavior – Allows handling. Gets stressed with cystocentesis and blood draw.
Evidence of Cruelty seen – None
Evidence of Trauma seen – None
Objective
P = 240
R = 30
BCS 6/9 with mild muscle wasting. MMs pink.
EENT: Eyes clear, mild grey wax AU. No nasal or ocular discharge noted
Oral Exam: Moderate tartar.
PLN: No enlargements noted
H/L: Grade 2/6 systolic murmur on the left side, mid-parasternal, very mild spreading of PMI. NSR, CRT < 2, Lungs clear, eupnic
ABD: Non painful, no masses palpated
U/G: Male neutered
MSI: Seborrhea sicca – moderate flaky skin on coat. Ambulatory x 4, skin free of parasites, no masses noted.
CNS: Mentation appropriate – no signs of neurologic abnormalities
Rectal: Normal externally.
Assessment:
1. Known diagnosis of CKD, on benazepril and aphogel (aluminum hydroxide) and may need SQF
2. Heart murmur
3. Dental disease
4. Seborrhea
5. Muscle wasting
Prognosis: Fair
Plan:
1. Run CBC/chemistry/T4 and urinalysis (cysto)
2. Continue Aphogel 64 mg 1.0 ml PO BID and benazepril 5 mg tabs, 1/4 tab PO SID x14 days
3. Feed kidney diets such as k/d or NF only
4. Recommend cardiologist evaluation after placement
5. Recommend daily tooth brushing and regular dental cleanings
6. Consider multivitamin or fish oil to enhance coat
CBC:
Hct 46.2%
WBC slightly elevated (18.78 k/ul), neuts slightly elevated (10.39 k/ul)
Eos elevated (2.83)!!
Chemistry:
BUN elevated (45), creat normal 1.5
Albumin normal (3.5 g/dl)
Globulins normal (4.7)
**Na severely elevated (>180 mmol/l)
Cl severely elevated (150 mmol/l)
T4 low end of normal (1.3 ug/dl)
Urinalysis (cysto)
Clear, bright yellow
USG >1.050
Blood in sample
Neg bili, ketones, glucose
Protein 2+
Leu seen on dipstick but not in microscopic exam
Blood pressure: 160/Doppler
ASSESSMENT:
1. Electrolyte derangements – severe hypernatremia and hyperchloremia – R/O CKD vs. salt poisoning vs. hyperadrenocorticism vs. diarrhea vs. hyperaldosteronism vs….
2. Leukogram – R/O stress leukogram
3. Hypersthenuria, proteinuria – R/O severe dehydration (not appreciated on exam) vs. UTI vs. other
4. Elevated BUN, normal creatinine – R/O CKD and muscle wasting vs. protein-rich meal vs. other
5. Hypertension – R/O primary hypertension vs. secondary to CKD vs. secondary to heart disease vs. other
6. Heart murmur
7. Muscle wasting
PLAN:
1. Place IVC and start LRS at 21 ml/hr (should correct 0.35 mEq sodium/hour)
2. Continue meds as scheduled
3. Repeat chemistry tomorrow
4. Try to get medical records from previous vet
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.
View all entries in: Safe Cats 2018-03