ROYALTY – A1091106
Safe - 9-30-2016 Brooklyn
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SAFE 09/29/16
ROYALTY – A1091106
FEMALE, WHITE / CREAM, CHIHUAHUA SH MIX, 12 yrs
STRAY – STRAY WAIT, NO HOLD Reason STRAY
Intake condition UNSPECIFIE Intake Date 09/24/2016, From NY 11229, DueOut Date09/27/2016
Medical Behavior Evaluation GREEN
Medical Summary Scanned negative QARH-tolerated all handling Intact female Approx 12yrs old Eyes- bilateral nuclear sclerosis; Stt (os-0mm, od-9mm); cleaned eyes and applied otimune- vc tomorrow Ears and nose- clear Teeth- severe tartar and staining; missing all premolar and incisors. No parasites or fleas seen Able to stand but did not walk on own. Long hind nails- trimmed nails NOSF
Weight 11.2
RE-EXAM :
09/25/16 : Geriatric exam and check eyes – KCS
O: QARH. mm=pink, moist, CRT<2 s. Oral: Multiple missing teeth, severe calculus and gingival recession. EENT: AU – tan debris, eythema, canal swelling. OU – mucoid discharge, mild scleral injection. OS – corneal melanosis, no menace response. STT done yesterday – below normal OU. H/L: No murmurs. ABD: Palpation WNL. MS: Overweight body condition. Amb x 4, no lameness. Integ: Scarring and mild erythema dorsum of left hind paw/metatarsal area. A: KCS OU, with blindness OS. Otitis externa. Dental disease. Overweight. P: Rx Optimmune oint. Apply OU BID. Continue long term. RX TAB-H oint. Apply OU BID. Continue long term. Rx Otomax oint. Apply 3 drops AU BID x 10 days. Rec placement. Prognosis good with appropriate therapy.
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