LEO – 17053

27/12/2017

DVM Intake Exam Estimated age: 2 yo Microchip noted on Intake? No Microchip Number (If Applicable): History: Pus in urine according to previous caretaker Subjective: BAR. 6-8% dehydration Observed Behavior – timid Evidence of Cruelty seen – no Evidence of Trauma seen – no Objective P = 140 R = 24 BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: wnl PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated, medium sized urinary bladder U/G: intact male (wnl) MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate – no signs of neurologic abnormalities Assessment: Possible FLUTD/Cystitis +/- UTI. Prognosis: good Plan: Treating for dehydration (150 ml LRS SQ fluids at time of exam) and possible UTI (1ml clavamox 62.5mg/ml PO). 500mg prazosin provided PO as well for any ongoing FLUTD/cystitis. Continued monitoring of urination and a short course of clavamox (62.5 mg PO bid for 5 days) with continued rehydration (100 ml LRS SQ Fluids q24 for 3 days). Prazosin 500 mg PO BID for 3 days being provided as well. SURGERY: Okay for surgery

27/12/2017

NO BLOODWORK RUN Urine Dipstick Results: 1+ blood 3+ protein pH 7 USG >1.050 Leukocytes 3+ No ketones, glucose, or bilirubin Cannot trust leukocytes on dipsticks. Suspect dehydration at this time. Will monitor for any signs of cystitis/FLUTD/UTI

28/12/2017

Progress exam-FLUTD History: Intake 12/27-suspect FLUTD/UTI. Started on SQ LRS, clavamox, and prazosin Urine Dipstick Results: 1+ blood 3+ protein pH 7 USG >1.050 Leukocytes 3+ No ketones, glucose, or bilirubin Subjective: BARH. Ate tuna well this morning. Normal u in litter box. Very vocal. No c/s/v/d. Objective P = wnl R = wnl BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated, medium sized soft urinary bladder U/G: MI, 2 testicles descended MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate – no signs of neurologic abnormalities Assessment: Possible FLUTD/Cystitis +/- UTI Dehydrated Prognosis: good Plan: Continue clavamox until 1/3 Continue SQ LRS until 12/30 Continue prazosin until 12/30 Start simbadol 0.24mg/kg SQ SID x3d until 12/30 Recheck daily

29/12/2017

Monitor FLUTD S/O: BARH. Nervous/timid with intermittent attention seeking behavior – head butts in cage but quickly backs away. Allowed all handling. Food appears untouched. Small amount of normal urine in litterbox from overnight. Observed sitting in litterbox, urinated very small amount EENT: Teeth clean, pink mm, eyes clear, no ocular or nasal discharge HL: Normal thoracic auscultation ABD: Soft, non tender, medium sized bladder, semi form but doesn’t feel thickened INTEG: Full, healthy coat MS: Ambulatory x 4 UG: Male A: FLUTD/cystitis, +/- UTI P: Continue with current treatment plan. Monitor urination throughout day, daily. Spraying felaway. Consider giving C/D diet, +/- adding amitriptyline with placement if symptoms continue. 4:30p – small/normal amount of normal urine in litterbox. Bladder soft, small. Doing well.

30/12/2017

Monitor FLUTD S/O: BARH. Very friendly today. Head-butting and seeking attention at all times. Eating tuna with good appetite. Other options less so. Large urination spot observed in litterbox alongside normal stool. EENT: Teeth clean, pink mm, eyes clear, no ocular or nasal discharge HL: Normal thoracic auscultation ABD: Soft, non tender, small urinary bladder. INTEG: Full, healthy coat MS: Ambulatory x 4 UG: Intact Male A: FLUTD/cystitis, +/- UTI P: Continue with current treatment plan (clavamox, prazosin, and simbadol). Monitor urination throughout day, daily. Spraying felaway. Consider giving C/D diet, +/- adding amitriptyline with placement if symptoms continue.

31/12/2017

Progress exam-FLUTD History: Intake 12/27-suspect FLUTD/UTI. Started on SQ LRS, clavamox, and prazosin Urine Dipstick Results: 1+ blood 3+ protein pH 7 USG >1.050 Leukocytes 3+ No ketones, glucose, or bilirubin Subjective: BARH. Ate tuna this morning. Normal u in litter box. No c/s/v but had some thick diarrhea in cage. Objective P = wnl R = wnl BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted ORAL: Clean adult dentition PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated, small sized soft urinary bladder U/G: MI, 2 testicles descended MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate – no signs of neurologic abnormalities Assessment: Possible FLUTD/Cystitis +/- UTI Hx dehydrated-resolved Prognosis: good Plan: Continue clavamox until 1/3 Continue prazosin until 1/3 Continue simbadol until 1/3 Start metronidazole 15mg/kg PO BID until 1/4 Recheck daily Consider c/d diet or amytryptiline if issue continues

2/01/2018

Progress exam-FLUTD History: Intake 12/27-suspect FLUTD/UTI. Started on SQ LRS, clavamox, and prazosin Urine Dipstick Results: 1+ blood 3+ protein pH 7 USG >1.050 Leukocytes 3+ No ketones, glucose, or bilirubin Subjective: BARH. Ate well this morning but is becoming more nervous in the cage. Normal u in litter box. No c/s/v but is still having diarrhea. Bladder is small and soft. Objective P = wnl R = wnl BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted ORAL: Clean adult dentition PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated, small sized soft urinary bladder U/G: MI, 2 testicles descended MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate – no signs of neurologic abnormalities Assessment: Possible FLUTD/Cystitis +/- UTI-resolved Hx dehydrated-resolved Diarrhea r/o abx vs other Prognosis: good Plan: Last day of clavamox, simbadol, and prazosin tomorrow Continue metronidazole 15mg/kg PO BID until 1/4 Recheck daily Parvocite when feces available in cage Rec fortiflora for diarrhea-likely related to abx but no fortiflora available at BACC Consider c/d diet or amytryptiline if issue continues

3/01/2018

Recheck Flutd S/O: BARH. Appetite OK. Very skittish today, difficult/not allowing handling (tense, head turning, very head shy -allowed abdominal palpation, started hypersalivating during interaction) EENT: Eyes clear, no ocular or nasal discharge HL: No sneezing ABD: Tense abdomen, soft bladder INTEG: Full healthy coat MS: Ambulatory x 4 UG: Male A: FLUTD, cystitis – has been doing well in shelter P: Continue with current treatment and monitoring plan. Good prognosis

Leo was a bit shy during intake but allowed all handling.