LIAM – 16860
Safe - 1-3-2018 Manhattan Rescue: Happy Homes Please honor your pledges: http://www.happyhomesinc.org/
*** SAFE 01/03/18 *** Poor Liam was not doing too good when he first arrived but his recovery is going well now @MACC. LIAM is a friendly 4 year old who was brought to the shelter with an abdominal wound/hernia after someone saw him on the street. Liam was given emergency surgery and needs further medical care while healing from his injury. Fostering will help this sweet cat get the care he needs to recuperate. If you can foster please email [email protected] for rescue info.
MANHATTAN CENTER
Hello, my name is Liam. My animal id is #16860. I am a male brown tabby cat at the Manhattan Animal Care Center. The shelter thinks I am about 4 years 1 weeks old. – P
I came into the shelter as a aco impound on 24-Dec-2017.
Zip Code: 10007
Liam is at risk for medical reasons. Liam came to us with his intestines completely exposed, and so underwent emergency surgery immediately. The surgery was successful, but Liam needs to complete his recovery outside the shelter environment. Behaviorally, we suggest that Liam would be best suited to a cat experienced home.
My medical notes are…
Weight: 8.7 lbs
DVM Intake Exam Estimated age: 3-5 years based on dentition and secondary sex characteristics Microchip noted on Intake? Scanned neg History : Pt was seen on the street this morning with his intestines hanging out Subjective: Quiet, alert, meows Observed Behavior – Allows all handling Evidence of Trauma seen – Jejunum hanging out of a large full-thickness wound to the ventral abdomen Objective P = 128 R = 100 BCS 5/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: Clean teeth. Small superficial wound to the upper lip over the left canine – and this tooth is chipped. PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, tachypneic ABD: Large full-thickness wound on ventral abdomen with intestines hanging out U/G: Male intact, testicles S/S MSI: No other wounds noted to body. Blood on hind legs. No masses noted, healthy hair coat. CNS: Dull Rectal: Normal externally Assessment: Full-thickness abdominal wound with intestines herniating onto exam table, covered in dirt, sticks and hair. Very little active bleeding. Intestines pink and vital. CBC/chem- hyperglycemia but no severe liver/kidney value derangements Prognosis: Poor Plan: 1. Emergency surgery 2. Hydromorphone 0.2 ml IM around 2:30pm 3. IVC placed 4. Ampicillin 0.6 ml administered IV slowly around 3pm 5. Baytril 0.85 ml administered IV slowly around 3pm 6. IV LRS started at 200 ml/hr SURGERY: Okay for neuter surgery after recovery from this injury 1088
Hx: Evisceration two days ago – emergency surgery to decontaminate intestines. Pt has been on ampicillin, enrofloxacin, Simbadol, Cerenia, robenacoxib. Urinated and defecated overnight. S: Alert, hisses at me. Tense. Allows exam. O: BAR-H, BCS 5/9, MMs pink and moist. Temp 100.1. EENT: No discharge OU, AU, nose. PLNs: Not significantly enlarged. H/L: NSR, NMA, HR 160. Slightly tachypneic. Quiet lung sounds. Abd: Soft, no pain on palpation! No masses palpated. M/S/I: Amb x4. Ventral abdomen is bruised around the incision – bruise is larger than previously, but more red and less purple. UG: Male intact, testicles soft and symmetrical. Neuro: Alert and appropriate, no sign neurological deficiencies A: Recovering well from evisceration, no sign of peritonitis Short-term prognosis: Fair P: 1. Pulled IVC during exam 2. Continue ampicillin 0.6 ml IM BID today – consider switching to oral Clavamox tomorrow 3. Continue Baytril 0.85 ml IM today – consider switching to oral tablets tomorrow 4. Continue Cerenia, Simbadol and Onsior as scheduled 5. Monitor appetite and defecation 6. Skin sutures to come out on 1/2/18 7. Okay to have regular litter (doesn’t need Yesterday’s News) 1088
Repeat CBC/chemistry: -ALT normalizing (was 354, now 210) -Hct 22% (was 37%) – expected hemodilution given the high fluid rate pt has been on -Normal neutrophils and white count, bands suspected -Thrombocytopenia (90 k/ul)- R/O machine error vs. consumption Continue with current tx plan. 1088
Hx: traumatic abdominal hernia with severe intestinal strangulation on intake; reduced on 12/24; doing well post-operatively S/O -QAR, allows gentle petting and handling but quickly begins to hiss and grumble -great appetite -normal stool in box today -mm lgt pk, sl tacky -no nasal discharge or sneezing -OU: open and clear -eupnic -does not allow abdominal palpation due to behavior but appears comfortable with no abdominal distension or other concerns -abdominal surgical wound appears CDI A 1. Abdominal hernia, reduced P -okay to d/c ampicillin and start clavamox drops 0.9 ml PO BID x 7 days
S/O -QAR, hisses when approached; allows gentle petting on head but no additional handling -good appetite -small episode of brown liquid diarrhea in box and normal bowel movement -mm appear pk when hissing -no nasal discharge or sneezing -OU: open and clear -appears eupnic -did not palpate abdomen due to behavior but appears soft with no distension or concerns -surgical wound on L side of abdomen appears to be healing well with no obvious discharge or significant swelling, unable to fully evaluate due to behavior A 1. Traumatic abdominal hernia, reduced, doing well post-op 2. Diarrhea-r/o secondary to clavamox vs other P -CWCT -Monitor for persistent diarrhea, consider adding metronidazole vs d/c clavamox
Recheck in med for wound repair: S/O: BARH, BCS 5/9, hissing/growling behav. limited PE – e/d u/d all ok – no c/s EENT clean/clear – healing abdominal incision is clean/dry/intact, no swelling/dishcarge A: healing incision P: cont. with current tx
Recheck in med for wound repair: S/O: BARH, BCS 5/9, hissing/growling behav. but allowed limited PE – e/d u/d all ok – no c/s EENT clean/clear – healing abdominal incision is clean/dry/intact, no swelling/dishcarge A: healing abdominal incision, looks good P: cont. with current tx, rec’ move out of medical
Hx: Traumatic evisceration – surgically repaired on 12/24/17. Recovered really well and has been eating/drinking and defecating well. Scheduled for suture removal today. S: Alert in kennel, hissing, growling and tense. Scruffed for brief exam. Stool in kennel – brown with some red tinges O: BAR-H, MMs pink EENT No discharge OU, AU, nose H/L: Eupnic, not ausculted Abd: Tense but no masses palpated, not distended M/S/I: No lesions noted. Suture line is healthy with no swelling/discharge/erythema. A: Recovery from evisceration. Traces of blood on stool – R/O parasites vs. GI trauma from evisceration vs. other P: Pyrantel, monitor stool 1088
Dexdomitor 0.08 ml IM at 3:15 Midazolam 0.25 ml IV at 3:20 Midazolam 0.05 ml IV at 3:30 Pt intubated with 3.5 Fr ET tube Covered exposed intestines and omentum with moistened gauze Shaved abd, prepped aseptically Draped the abdomen. Heavily lavaged the exposed intestines with warmed LRS to remove as much debris as possible. A small amount of omentum was unable to be cleaned well and so it was ligated with a modified Miller’s knot using 2-0 PDS and then removed. Drape and gloves were changed. Intestines were lavaged again – debris already in the lymphatics and vasculature was unable to be removed but 90% of the rest of the debris was removed. The root of the mesentery and everything coming from it was exterior to the body – including all of the jejunum, the ileum and the cecum. The root of the mesentery was red-purple. Occasional small areas along the jejunum and the jejunal vasculature were abraded – the adventitia only, not deeper. The intestines were replaced into the body, and the abdomen was flushed several times with large quantities of warmed LRS. Drape and gloves changed again. The hernia was explored. The incision was to the right of midline, about 8 cm long with the distal end about 1 cm cranial to the umbilicus. The cut was almost entirely straight with a small flap (1 cm) of muscle that made one jagged edge. Purple-red bruising was noted to the right of the incision. The body wall was closed with 3-0 PDS in a simple interrupted pattern. The superficial musculature was closed with 3-0 PDS in a simple interrupted pattern. The SQ tissue was closed with 3-0 PDS in a simple interrupted pattern. The skin was closed with 3-0 PDS in a Ford interlocking pattern. Anesthetically, pt initially had hypertension (212/200). After the intestines were replaced, pt had several episodes of hypotension (76/33 MAP 55) – managed by decreasing the isoflurane and giving epinephrine. Pt recovered slowly. POST-OP INSTRUCTIONS 1. E-collar 2. Ampicillin 0.6 ml IV q8 – at 11pm, 7am, 3pm 3. Baytril 0.85 ml IV q24 – 3pm 4. Simbadol 0.5 ml SQ SID in evening 5. Cerenia 0.4 ml IV SID in evening 6. Onsior 0.4 ml SQ SID 7. IV LRS at 25 ml/hr overnight 8. Monitor appetite and eliminations 1088
Details on my behavior are…
Behavior Condition: 1. Green
found as stray no Hx avail captured in net-transferred to hard carrier- cat was cooperative
Date of Intake: 12/24/2017
If yes, Please elaborate:: Found as stray no Hx avail
KNOWN HISTORY:: Liam was brought in as a stray, so we don’t have any behavioral history or tendencies in a home environment.”
ENRICHMENT NOTES:: 12/26/17 Severe abdominal injury. Resting at back, eyes a little dilated, on several medications. Lay in place when door opened. Allowed head pets, but put ears sideways and growled quietly. Ate offered treats. 12/27/17 Resting on bedding, alert, looking around, eyes a little dilated. Came to the front when spoken to, sniffed hand between the bars. Retreated a few steps when door opened, then sniffed hand again. Briefly flinched away when first touched, then leaned into pets, purred, closed eyes. 12/28/17 Resting towards back, eyes a little dilated, soft posture. Lay in place when door opened, leaned into pets head, whined and hissed when pet on rear. Ate offered treats, came slowly forward for more. 12/31/17 Dozing under kuranda bed, behind bedding. Woke when door opened. Lay in place, soft eyes and body, leaned forward to eat offered treats, then stood and came to the front. Leaned into pets, purred, allowed touch all along body.
Cage Condition:: Cage is slightly re-arranged
Reaction to assessor:: Liam remains neutral. lying down on his cage bedding during the approach.
Reaction when softly spoken to:: Liam remains immobile in place.
Reaction to cage door opening:: Liam becomes alert with normal shape eyes, ears erect and forward.
Reaction to touch:: Liam accepts the touch, but slowly increases distance and began to low grumble during the interaction.
ACTIVITY LEVEL:: Laid back
VOCAL:: Quiet
CHARACTER TYPE: : Independent
BEHAVIOR DETERMINATION: : Experience
Behavior Asilomar: TM – Treatable-Manageable
BEHAVIOR SUMMARY:: Liam tolerates attention and petting but may be fearful or stressed in the shelter. We recommend that this cat go to a home with experienced cat parents.
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