ACE – 19227

ACE – 19227

***NEEDS FOLLOW UP VET CARE***

Location: Manhattan; Intake Date: 1/26/18; Intake Type: Owner Surrender

Medical Behavior: Blue; Sex: Male; Age: 5 years; Weight: 66.6 lbs;

Original  Location: 11213

DVM Intake Exam: Estimated age: 5y Microchip noted on Intake? N Microchip Number (If Applicable):NHistory :owner surrender – owner reports no eating or defecating for 3 days (vet care not sought) Subjective: bar, overweight w/ bad odor Observed Behavior – muzzled b/c nervous. Objective:  T = 100.4  P = 100 bpm R = wnl/ne. BCS 7/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: muzzled, but teeth good condition and pink  PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Resents palpation of cranial abdomen, but no specific masses palpated, overweight and tense overall. U/G: mn, large prostate, but smooth, symmetrical and nonpainful, no stool in rectum MSI: Ambulatory x 4, skin free of parasites, no masses noted, dry hair coat CNS: Mentation appropriate – no signs of neurologic abnormalities Rectal: see above, prostate wnl for middle-aged intact male dog  Assessment: 5 yr mi x 2 large breed dog inappetant and lack of bm x 3 days, bilious vomiting after exam and treatment. dry hair coat. r/o fb (strongly suspected) vs mass vs pancreatitis vs other infection/inflammatory  Prognosis: short term – guarded to good w/ surgical intervention. Long term – needs wt loss 10# Plan: lat and vd abdomen. cbc/chem/lytes/t4. 1 L sqf 3 cc cerenia sq. 3 cc convenia sq. 1.5 cc hydromorphone sq  rads suspicious for fb vs mass rec: abdo us vs exploratory sx. ctm o/n and possible transfer via rescue group tomorrow.  SURGERY:  Temporary waiver due to not eating and possible illness. Radiographs strongly suggestive of either foreign body – gastric and possibly small bowel vs mass effect cranial to mid abdomen. Decrease in serosal detail. gas distended abdo and loops of bowel w/ intestines pushed to right lateral on vd view. large piece of firm stool distending descending colon on lateral view. mod non-regenerative anemia. hyponatremia and hypochloremia. band neutrophils. monocytosis increase in alt 388. T4=0.6 suspect euthyroid sic syndrome

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