Senior Kitty WARREN! in NYC Brooklyn

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Senior Kitty WARREN! NEEDS VET CARE ASAP FOR SUPPORTIVE CARE, ULTRASOUND & ECHOCARDIOGRAM! ACC NYC - Brooklyn Center Warren is a thin old guy with icterus and an abdominal mass. He is stable and eating but will need supportive care, an ultrasound, and an echocardiogram ASAP at a private vet. PLEASE HELP HIM TODAY!
53292 – Warren 10 yr. old neutered male orange/white cat, stray Medical: 1/23/2019 FeLV/FIV Snap Negative 23-Jan-2019 DVM Intake Blood Work Interpretation Vet Notes: 6:52 PM CBC: Mild nonregenerative anemia, Hct 24.7% Severe Leukocytosis, neutrophilia, monocytosis, eosinophilia, basophilia. Chem: Elevated ALT 254 (12-130) Elevated ALP 212 (14-111) Elevated GGT 35 (0-4) Severe hyperbilirubinemia 13.0 (0.0-0.9) T4 wnl Assessment: Anemia - ro chronic dz vs loss (bleeding mass) vs other Leukocytosis/neutrophilia/etc - ro inflammation/neoplasia/infection Hepatopathy - infectious vs inflammatory vs neoplasia vs toxin Plan: Scheduled AXR tomorrow to eval abdominal mass Recommend AUS and additional workup vs continue supportive care if responding vs EHR Vet Notes: 6:27 PM DVM Intake Exam Estimated age: Approx 10 years Microchip noted on Intake? Negative History : Stray Subjective: BAR, friendly, enjoys petting, purring, eating food offered! Allows all handling. Evidence of Cruelty seen - none Evidence of Trauma seen - none Objective P = wnl R = wnl BCS = 3/9 EENT: Eyes clear with icteric conjunctiva. Ears - light brown discharge AU, inner pinnae icteric AU. No nasal or ocular discharge noted Oral Exam: mild-mod tartar with suspected resorption, mm icteric and mildly tacky PLN: No enlargements noted H/L: Grade I/VI heart murmur, Lungs clear, eupnic ABD: Non painful, suspect mid abdominal mass - approx 4cm diam U/G: Male neutered MSI: Ambulatory x 4, skin free of parasites, no masses noted, dull haircoat with prolonged skin tent CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: Externally normal Assessment: Icterus - ro primary hepatopathy (infectious/neoplastic) vs secondary Dehydration Abdominal mass - ro neoplasia vs stool vs other Heart murmur - ro secondary to dehydration vs cardiopathy vs other Dental disease Underweight Prognosis: Guarded Plan: CBC/Chem/T4 SQF 100 ml Convenia 0.4 ml SQ Cerenia 0.4 ml SQ Keep in medical - monitor appetite, v/d, etc Scheduled for AXR tomorrow. If abdominal mass confirmed, consider placement with NH for workup vs EHR 24-Jan-2019 Progress Exam Radiograph Review Vet Notes: 8:41 AM Progress exam History : Stray intake 1/23-icterus, dehydrated, abdominal mass, HM, dental disease, underweight. Gave convenia, SQF, and cerenia. CBC: Mild nonregenerative anemia, Hct 24.7% Severe Leukocytosis, neutrophilia, monocytosis, eosinophilia, basophilia. Chem: Elevated ALT 254 (12-130) Elevated ALP 212 (14-111) Elevated GGT 35 (0-4) Severe hyperbilirubinemia 13.0 (0.0-0.9) T4 wnl Subjective: BAR, ~5% dehydrated. No csvd. Eating well. Normal U, no BM. Objective P = wnl R = wnl BCS = 3/9 EENT: Eyes clear with icteric conjunctiva. Ears have mild debris, pinna icteric AU, No nasal or ocular discharge noted Oral Exam: moderate dental disease with severe icterus, dry mm PLN: No enlargements noted H/L: NMA, RR, Lungs clear, eupneic ABD: SNP, ~3cm firm abdominal mass in cranial abdomen U/G: MM MSI: Ambulatory x 4, skin free of parasites, no masses noted, icteric, dull haircoat, cachexia CNS: Mentation appropriate - no signs of neurologic abnormalities Assessment: Icterus - ro primary hepatopathy (infectious/neoplastic) vs secondary Dehydration Abdominal mass - ro neoplasia vs stool vs other Heart murmur - ro secondary to dehydration vs cardiopathy vs other-NOT AUSCULTED TODAY Dental disease Underweight Anemia - ro chronic dz vs loss (bleeding mass) vs other Leukocytosis/neutrophilia/etc - ro inflammation/neoplasia/infection Hepatopathy - infectious vs inflammatory vs neoplasia vs toxin Prognosis: Guarded Plan: Keep in medical - monitor appetite, v/d, etc Rec placement ASAP for supportive care, AUS, +/- histopath, echocardopgram Continue LRS 20ml/kg SQ SID x3d until 1/27 3 view AXR-decreased serosal detail, small amount of ingesta in stomach, mass effect in mid-cranial abdomen on lateral AXR, no other obvious abnormalities

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