LILLY – A1034130
SAFE – 04/28/15
LILLY – A1034130
FEMALE, BROWN / WHITE, BEAGLE, 10 yrs
STRAY – STRAY WAIT, NO HOLD Reason STRAY
Intake condition ILLNESS Intake Date 04/23/2015, From NY 11356, DueOut Date 04/26/2015,
Medical Behavior Evaluation GREEN
Medical Summary scan negative intact female – no spay scar seen weight: 27.4lbs hold up left front leg but than walks on it nails were long – cut nails cloudy eyes skin tag around muzzle right side clean ears clean coat – flea negative moderate dental tartar broken canines seen has a small mass on the right side of her belly across from umbilicus allowed all handling to be preformed for exam – no signs of aggression QARH NOSF
S/O: Patient is BAR on presentation. Eating very well, No c/s/v/d. Cooperative for exam, easy handling., mm = pink, moist, CRT < 2 sec., hydration = slightly prolonged skin tenting, Integ = Several skin tags throughout body – one on left muzzle area (approx. 1-2 mm, another located on left lateral neck region (Approx 0.5 cm), dull but kempt coat. Multifocal areas of erythema (dermatitis) around the caudal ventral region. , EENT = nuclear sclerosis, OU, clean ears, AU, nnd, severe periodontal disease (staining, tartar) and wearing of dentition, fractured upper canine teeth, H/L = nma, nsr, Abdomen =snp, moderately distended abdomen (Pot bellied appearance), no masses palpated, GU = no MGTs, no vaginal discharge. , LN = wnl, MS = BCS: 7/9; Moderate lameness on gait assessment – appears to be weight bearing however. orthopedic exam revealed decreased PROM of the LFL (shoulder joint) when compared to the RFL. Crepitus palpated in the LF shoulder joint. Slight pain elicited on palpation of the metacarpal/digital region on the left front paw. , CNS =Appropriate
distended abdomen – r/o primary GI disease vs. fat vs. fluid vs. pregnancy vs. primary endocrinopathy (likely) vs. other
LFL lameness – r/o soft tissue vs. orthopedic (arthritis likely)
- Blood work – due to geriatric
- Start course of Rimadyl – 25 mg PO BID x 5 days
- Continue to monitor for lameness – recheck at end of treatment. If no improvement, consider radiographs.
CBC/chemistry revealed the following:
Azotemia (BUN = 58 mg/dL), Mild hyperphosphatemia (7.3 mg/dL), Mild eosinopenia, Mild basophilia
sweet, old doggie, easy to handle
PLAYGROUP BEHAVIOR: When off leash with other dogs Lilly is social and greets well, although she does not engage in play she enjoys being around the other dogs.
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