SNOWFLAKE – A1104850

SNOWFLAKE – A1104850

**PARALYZED – NEEDS NEW HOPE PLACEMENT **

SPAYED FEMALE, WHITE, MALTESE / POODLE MIN, 10 yrs
STRAY – STRAY WAIT, NO HOLD Reason STRAY
Intake condition GERIATRIC Intake Date 02/27/2017, From NY 11212, DueOut Date

Medical Behavior Evaluation No Initial Behavior
Medical Summary Scan : neg. Sex: female spayed (green linear tattoo ventral abdomen). Est age: 10-12 years. T-100 P-120 R-40

S/O: Dog is QAR, in lateral recumbency. BCS 6+/9. EENT – NS OU; bilateral mucoid nasal discharge. Grade 3-4/4 dental dz. H/L – referred upper airway sounds; no obvious murmur or arrhythmia. Abdomen distended. Non-ambulatory; weak-absent w/d all four limbs; flaccid hindlimbs; rigid forelimbs with motor. U/G – large bladder on right abdominal radiograph, expressed with mild difficulty, dark yellow urine. Skin/coat-multiple dermal masses (ddx: adenoma(s), basal cell tumors, open); approx 3cm soft mammary mass (50/50 benign or malignant); all nails overgrown, curling. Offered food – app++

A: Geriatric underlying – paralyzed in hind limbs, non-ambulatory in forelimbs DDx: IVDD, Trauma, Neoplasia, Open

P: Right lateral abdominal radiograph reveals very large bladder, no radiopaque stones; stool in colon; otherwise unremarkable. Bloodwork shows moderate non-regenerative anemia (HCT 27.1%), mildly inc ALKP, CHOL, GLOB, GLU, and TP. Urine dip stick was ++ for bilirubin, Protein 30, pH 5, and USG 1.043 (by refractometer). Trimmed nails.  Will inform NH to seek placement.  Due to condition (paralysis) and dog unable to urinate on own needs deadline of 6pm 2/28/17.  Start on buprenorphine IM q12h for pain while here. Express bladder q12h while here.  Assist to E/D q12h while here.

PROGNOSIS: POOR – unable to determine how long dog has been without deep pain, but px for recovery of limb function is poor.  Needs advanced imaging (CT or MRI) to help dx cause of paralysis (i.e. IVDD, spinal tumor, etc.)

RE-EXAM

02/28/17 : S/O: QARH. mm=lt pink, moist, CRT<2 s. Resting in lateral recumbency but attempts to sit up when approached. Excellent appetite, drinking well. ORAL: Significant dental calculus, areas of gingival recession. EENT: Nuclear sclerosis OU. No oculonasal discharge. H/L: HR=100, RR=28. Lungs clear, no murmurs/arrhythmias. ABD/UG: Soft, non-painful. Mod. pot-bellied appearance. MS/NEURO: Able to sit upright and maintain a sitting position on her own. Able to walk with front legs using a towel sling to hold rear end up. No forelimb ataxia or CP deficits.  Hind limbs flaccid, collapse when placed down. Pos. withdrawal bilaterally, no apparent deep pain. INTEG: Thin haircoat, esp over thorax, lumbar region, tail.

A: Geriatric dog with bilateral hind limb paralysis. DDx: IVDD, other spinal injury (trauma, tumor, FCE). Thin haircoat DDx: Hypothyroidism, Cushing’s disease.  Overall, clinical signs improved from yesterday and dog appears brighter, more comfortable.

P: Continue Buprenorphine as planned. Continue supportive care, including short walks outside to see if she will voluntarily urinate/defecate. Guarded prognosis. Still needs placement with New Hope, but removed deadline as she is more comfortable and stable.

 

 

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