TWINKLES – 16339
Safe - 12-28-2017 Manhattan
SAFE 12/28/17 Kitten girl Twinkles has paralyzed hindlegs and needs some love @MACC
Manhattan Center
16339 Twinkles 5m Female Brown Tabby Domestic Short Hair 6.7lbs
Stray:12/17/2017
Medical
Vet Consultations
Date
Reasons
Vet Notes
Vet
Date Resolved
19-Dec-2017
Progress Exam
Vet Notes: 2:47 PM
S/O
-BAR, interactive and affectionate; euphoria secondary to simbadol administration
-great appetite, litterbox already cleaned this morning
-mm pk, moist; CRT <2 sec
-no nasal discharge or sneezing
-OU: open and clear
-eupnic, purring loudly on auscultation
-slightly tense abdomen on palpation, bladder too small to palpate
-severe paraparesis, ambulatory with assistance today; has strong voluntary motor in hind limbs and is able to bear weight for short periods of time
-decreased withdrawal on hindlimbs
A
1. Paraparesis, severe but improving
P
-continue simbadol
-add gabapentin 50 mg/ml: 0.4 ml PO BID
-start prednisone 2.5 mg PO SID tomorrow
-ideally would have neurologist consult after placement to confirm diagnosis of traumatic disk herniation; her overall condition appears to be improving and she will likely require 8 weeks of crate rest and pain management but surgery may not be necessary; she would likely benefit from rehabilitation including cold laser therapy +/- acupuncture
VET
18-Dec-2017
Progress Exam
Radiograph Review
Vet Notes: 4:03 PM
Radiographs of hindlimbs-NSF
Vet Notes: 4:01 PM
Hx: presented with severe paraparesis; radiographs did not show any orthopedic concerns of hind end or spine; given one dose of onsior and one dose of simbadol last night
S/O
-BAR, very interactive and affectionate; euphoria secondary to simbadol
-great appetite
-mm pk, moist
-no nasal discharge or sneezing
-eupnic, heart/lungs WNL
-soft abdomen
-severe paraparesis, appears to have voluntary motor movement in both limbs; bears weight rarely RH; sits appropriately but drags hindlimbs around cage
-bladder small and soft
-anal tone present
A
1. Paraparesis, radiographs negative-r/o traumatic IVDD vs congenital vs other
P
-dexamethasone SP 4 mg/ml: gave 0.2 ml SQ
-continue simbadol 0.3 ml SID x 4 days
-monitor for improvement or regression; if not improving or condition deteriorates, consider EHR
-if improving, then recommend placement in order to pursue neurologic consultation +/- MRI to definitively diagnose underlying condition
VET
17-Dec-2017
DVM Intake
L V T Notes: 4:25 PM
Gave simbadol 0.27ml from bottle numbers 44 &45 (0.2mL from bottle 44 and 0.07ml from bottle #45) SQ at 4:00pm
DVM 1444
LVT 1215
also gave onsior 0.2mL SQ
100ml SQ LRS given
PCV- 32%
TP- 7.0 g/dl
Vet Notes: 3:47 PM
[DVM Intake]
DVM Intake Exam
Estimated age: 5m
Microchip noted on Intake? n
History : stray
Subjective:bar
Observed Behavior – scared/painful but allows all handling
Evidence of Cruelty seen -n
Evidence of Trauma seen -n
Objective
T =
P = 160
R = wnl
BCS 5/9
EENT: Eyes clear, ears clean, no nasal or ocular discharge noted
Oral Exam: 5m based on adult dentitia
PLN: No enlargements noted
H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic
ABD: Non painful, no masses palpated
U/G: fi
MSI: Ambulatory x 3, splaying and knuckling left hind, suspect pelvic fx, skin free of parasites, no masses noted, healthy hair coat
CNS: Mentation appropriate – no signs of neurologic abnormalities, tail tone present
Rectal: did not do
Assessment:
suspect pelvic fracture, more affected left side/hindlimb vs hip sublux or fx
Prognosis: good to excellent with tx
Plan: 100 cc lrs sq
0.27 cc simbodol sq
0.20 cc onsior sq
pcv/ts
x-rays lat/vd thorax
lat/vd pelvis/spine/hindlegs
Possible fx to left acetabulum, but no other overt changes to account for current signs.
R/O spinal shock other unknown trauma/injury
SURGERY:
Temporary waiver due to
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