Weight: 59.2 lbs

11/02/2018

[DVM Intake] DVM Intake Exam Estimated age: 8-9y Microchip noted on Intake?y Microchip Number (If Applicable):985121005301578 History :owner surrender Subjective:bar Observed Behavior – allowed petting and all handling Evidence of Cruelty seen -n, but potentially has chronic injury RH and severe, ulcerated callus LH tarsal area Evidence of Trauma seen -n Objective T = P = 100 R = wnl BCS 5/9 EENT: Eyes clear, mild superficial debris au, no nasal or ocular discharge noted Oral Exam: worn teeth and fractured max k9 teeth PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, no masses palpated U/G: mn MSI: wt bearing lame rh w/ exaggerated lateral rotation from hip and stifle, possible bilateral medially luxating patellas, seems to be painful hips bilaterally, lordosis and possible pain ls area, thick ulcerated callus on left tarsus and 1 cm cyst or wart right lateral hip area CNS: Mentation appropriate – no signs of neurologic abnormalities Rectal:ne Assessment: 8-9 yr mn large mixed-breed dog lameness RH – r/o mpl’s vs osteoarthritis vs other ortho injury hip mass – sebaceuous cyst vs wart vs other benign callus – ulcerated callus from leaning/sleeping more on left side (right hind lameness and likely oa) Prognosis: good to excellent w/ nsaid, jt supplements, fish oil, PT/proper exercise Plan: gave 1.2 cc sq rimadyl today starting 50mg po bid tomorrow gabapentin 300 mg po bid rec: continue rimadyl tomorrow cbc/chem/t4 hip/stifle and LS rads +/- under sedation appropriate anesthetic oral care upon placement/adoption SURGERY: na

12/02/2018

Rads of stifles, pelvis, and lumbar spine. Pelvis and lumbar spine NSF. OA and sclerotic changes to both stifles, likely secondary to bilateral CCL tares. Both stifles palpate thickened and have crepitus. P: Due to old age, not a candidate for bilat CCL repair. Continue to manage medically with long term carprofen and gabapentin or tramadol, with regular rechecks and bloodwork.

12/02/2018

PLT high 497 (148-484) PCT high 0.54% (0.14 – 0.46) TT4 low 0.8 (1.0 – 4.0) A: thrombocytosis – r/o secondary to inflammation vs other low T4 – r/o hypothyroidism vs euthyroid sick vs other P: Once placed/transferred/adopted, recommend full thyroid panel with FT4 and TSH

19/02/2018

Reportedly lethargic with a moist cough this afternoon S/O -QAR, docile and sweet, good boy, allows all handling -mm pk, tacky; CRT 2 sec -mild mucoserous nasal discharge -intermittent harsh cough -eupnic, clear lung sounds -soft abdomen -arthritis in all limbs -healing pressure sore/callous over L hock -small cutaneous growth on R thigh A 1. CIRDC P -500 ml SQF SID x 3 days, gave first dose -gave 3 ml cerenia SQ, continue 30 mg PO SID x 3 days starting tomorrow -doxycycline 300 mg PO SID x 14 days, gave first dose

20/02/2018

Diagnosed with CIRDC yesterday, kept in medical iso for monitoring due to geriatric status S/O -QAR/BAR, appears brighter than yesterday but is overall a very docile boy; sweet and allows all handling -good appetite -mm pk, moist; CRT <2 sec -intermittent harsh cough, sneezed once through AM -eupnic, clear lung sounds -soft abdomen -stiff gait x 4, stifle and carpal arthritis A 1. CIRDC 2. Geriatric 3. Osteoarthritis P -CWCT -restart rimadyl 50 mg PO BID x 7 days -add tramadol 100 mg PO BID x 7 days -recommend long term pain management protocol after placement for athritis (NSAID, tramadol, amantadine, cold laser, gabapentin, etc)

21/02/2018

CIRDC, osteoarthritis; restarted rimadyl and added tramadol yesterday; blood work unremarkable aside from slightly low T4 S/O -QAR/BAR, friendly, docile and sweet boy! -no significant appetite today -mm pk, tacky; CRT <2 sec -mild serous nasal discharge -intermittent quiet but harsh cough -eupnic, clear lung sounds; no murmurs or arrhythmias -gait still appears stiff but improved A 1. CIRDC 2. Inappetance today-r/o secondary to Tramadol vs early pneumonia vs other 3. Mild dehydration 4. Geriatric, possible hypothyroid 5. Osteoarthritis P -d/c tramadol, consider restarting again once he is cleared of CIRDC but want to avoid any sedative effect that may have negative affect on appetite -Placed IVC, LRS at 50 ml/hr overnight -re-evaluate in AM, suspect decreased appetite is due to tramadol administration but if appetite does not improve with fluids, then consider sedated chest radiographs tomorrow to rule out pneumonia

22/02/2018

Seemed a little dehydrated yesterday so was started on IVF overnight, being treated for CIRDC; was on tramadol but was discontinued yesterday due to concerns that it was making him sedate or affecting his appetite S/O -QAR, docile and friendly, allows all handling -good appetite -mm pk, sl tacky; CRT <2 sec -no nasal discharge, mild cough noted once -eupnic, quiet lung sounds -soft abomdne -significant stifle and elbow arthritis, stiff gait x 4 A 1. CIRDC 2. Dehydration, mild-r/o secondary to CIRDC vs other 3. Geriatric 4. Osteoarthritis P -decrease IVF to 40 ml/hr overnight, if doing well tomorrow then okay to d/c