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Case #4

History:

Loose stool for 5 days or so. No vomiting, patient is eating/drinking normally. Case #4 does have a history of getting things out of the garbage.
Vaccine status: Owner thinks they have had the patient vaccinated once since they adopted him 3 years ago, not sure where the records are.

PE: T: 102.2 HR: 124 Resp: 20 CRT: WNL

  • Rectal exam: loose, green poop

Diagnostics:

  • Fecal: negative
  • Owner declined bloodwork/HWT today

Treatment:

  • Metronidazole
  • Bland diet: canned RC GI LF

Recheck: 1 week later

  • Case #4’s diarrhea has resolved per the owner

PE: T: 101.6 HR: 116 Resp: 20 CRT : WNL

    • Normal poop on rectal exam
    • Found a tooth on upper right arcade that is discolored, has severe tartar buildup and gingivitis
      • Recommend dental prophy and likely extraction of that tooth
      • Rest of teeth: grade 1 dental tartar
      • Time to address vaccine/preventative issues

Diagnostics:

      • HWT: negative
      • CBC/Chem (pre op bloodwork for dental): WNL

Treatments:

      • 1st DHLPP
      • 1 year Rabies vaccine
      • Owner declined Bordetella and CIV series
      • Start on HWP

Recheck: Dental prophy

PE: T: 101.6 HR: 124 Resp: 16 CRT : WNL

    • Perform dental prophy and radiographs
      • Upper right 3rd premolar has a carious lesion and radiograph revealed severe loss of bony attachments around the root
      • Radiographs revealed 2 lower incisors that also warranted extraction
      • TGH on Clindamycin and Carprofen
      • Recheck in 2 weeks, booster DHLPP at that time unless owner has provided records that prove the patient doesn’t require a booster
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Tennessee Avenue Animal Hospital

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