Neemsc CASE Portfolios PDF

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Case Portfolio

Case #1 Signalment: 31 year old Shetland Pony, Palomino, Mare Presenting Complaint: OD 3rd eyelid protruding, want head CT and possible surgery Diagnostic Tests: Physical Exam- TPR, Head CT Diagnosis: Neoplasia Treatment Plan: 1/30 Stall rest, ½ tab Prascend PO SID, ½ tab Equioxx PO SID, 1/31 ½ tab Prascend PO SID, 5.5 ml Banamine IV PRE-OP, 11ML Nexcel IV BID, 16.5ml Gent IV PRE-OP 8AM, 250# Gastroguard PO SID, 5.5ml Banamine IV PRN 4PM, 0.75ml Butorphanol IM PRN, 1 L +80 ml DMSO IV PRN, 1.5ml Morphine PM PRN, 4ml Banamine IV PRN 12AM 2/1 ½ Tab Prascend PO SID, 8 Tabs SMZ PO BID, 250# Gastroguard PO SID, 1L +80 ml DMSO IV PRN, 5.5ml Banamine IV BID, ¼ inch strip neopoly bac OS QID, 8 tabs Gabapentin PO BID, 1ml Tetanus Toxoid IM Once, 6ml Elevate PO SID, 1.5ml Morphine IM PRN, 2/2 ½ Tab Prascend PO SID, 8 tabs SMZ PO BID, 250# Gastroguard PO SID, 1 L +80 ml DMSO IV PRN, ¼ inch strip neopoly bac OS QID, 8 tabs Gabapentin PO BID, 5ml Banamine IB BID 2/3 ½ Tab Prascend PO SID, 8 tabs SMZ PO BID, 250# Gastroguard PO SID, 1 L +80 ml DMSO IV PRN, ¼ inch strip neopoly bac OS QID, 8 Tabs Gabapentin PO BID, 5ml Banamine IB BID, 6ml Elevate PO SID, 1 scoop Well Gel PO q4hrs, 2/4 8 Tabs SMZ PO BID, 250# Gastroguard PO SID, ¼ inch strip neopoly bac OS QID, 6ml Elevate PO SID, 1 scoop Well Gel PO q4hrs, 6 tabs Sucralfate PO TID 2/5 8 Tabs SMZ PO BID, 250# Gastroguard PO SID, ¼ inch strip neopoly bac OS QID, 6ml Elevate PO SID, 6 tabs Sucralfate PO TID 2/6

¼ inch strip neopoly bac OS QID, 6ml Elevate PO SID, 6 tabs Sucralfate PO TID, 8 tabs SMZ PO BID, 250# Gastroguard PO SID, 1 scoop Wel Gel PO as needed for food 2/7 8 tabs SMZ PO BID, 250# Gastroguard PO SID, ¼ inch strip neopoly bac OS QID, 6ml Elevate PO SID, 6 tabs Sucralfate PO TID, 2/8 8 tabs SMZ PO BID, 250# Gastroguard PO SID, ¼ inch strip neopoly bac OS QID, 6ml Elevate PO SID, 6 tabs Sucralfate PO TID, 1 scoop wel gel PO as needed for food 4pm/12am, 5ml Banamine PO PRN, 0.5ml Butorphanol IM PRN. 2/9 8 tabs SMZ PO BID, 250# Gastroguard PO SID, ¼ inch strip neopoly bac OS QID, 6ml Elevate PO SID, 6 tabs Sucralfate PO TID, 5ml Banamine PO PRN. 2/10 8 tabs SMZ PO BID, ¼ inch strip neopoly bac OS QID, 6ml Elevate PO SID, 6 tabs Sucralfate PO TID, 5ml Banamine IV SID.

Skills/Tasks Performed: Physical Therapy, restrain for venipuncture, run CBC, PCV/TS, FIB

Case #2 Signalment: Alexa Presenting Complaint: Flush joint, colic work up Diagnostic Testing: Physical Exam, TPR, Colic work up Diagnostic: Infected Joint, Laminitis Treatment Plan: 1/28 11 tabs petoxy PO BID, 1 tab of prascend PO SID, 250# gastroguard PO SID, 20 tabs Tylenol PO BID, 7ml Bute IV BID, 50ml Chloramphenicol PO QID, 1/29 11 tabs petoxy PO BID, 1 tab of prascend PO SID, 250# gastroguard PO SID, 20 tabs Tylenol PO BID, 7ml Bute IV BID, 50ml Chloramphenicol PO QID

1/30 11 tabs petoxy PO BID, 1 tab of prascend PO SID, 250# gastroguard PO SID, 20 tabs Tylenol PO BID, 50ml Chloramphenicol PO QID, 5ml Bute IV BID, 1/31 11 tabs petoxy PO BID, 1 tab of prascend PO SID, 250# gastroguard PO SID, 20 tabs Tylenol PO SID, 50ml Chloramphenicol PO QID, 5ml Bute IV BID 2/1 11 tabs petoxy PO BID, 1 tab of prascend PO SID, 250# gastroguard PO SID, 50ml Chloramphenicol PO QID, 5ml Bute IV BID, 20 tabs Tylenol PO SID, 2/2 11 tabs petoxy PO BID, 1 tab of prascend PO SID, 250# gastroguard PO SID, 50ml Chloramphenicol PO QID, 5ml Bute IV BID, 20 tabs Tylenol PO SID, 3ml Morphine IV PRN 2/3 11 tabs petoxy PO BID, 1 tab of prascend PO SID, 250# gastroguard PO SID, 50ml Chloramphenicol PO QID, 5ml Bute IV BID, 20 tabs Tylenol PO SID, 3ml Morphine IV PRN, 20ml Equiotic Paste PO ONCE. 2/4 11 tabs Pentoxy PO BID, 1 tab Prascend PO SID, 250# Gastroguard PO SID, 20 tabs Tylenol PO SID, 50ml Chloramphenicol PO TID, 5ml Bute IV BID, 20 ml Equiotic Paste PO SID 2/5 11 tabs Pentoxy PO BID, 1 tab Prascend PO SID, 250# Gastroguard PO SID, 20 tabs Tylenol PO SID, 50ml Chloramphenicol PO TID, 5ml Bute IV BID, 20 ml Equiotic Paste PO SID, 1 gram Bute PO BID, 3ml Morphine IM PRN 2/6 11 tabs Pentoxy PO BID, 1 tab Prascend PO SID, 250# Gastroguard PO SID, 20 tabs Tylenol PO SID, 50ml Chloramphenicol PO TID, 20 ml Equiotic Paste PO SID, 3ml Morphine IM PRN, 1 gram Bute PO BID, 2/7 11 tabs Pentoxy PO BID, 1 tab Prascend PO SID, 250# Gastroguard PO SID, 20 tabs Tylenol PO SID, 50ml Chloramphenicol PO TID, 20 ml Equiotic Paste PO SID, 1 gram Bute PO BID, 3 ml Morphine IM PRN, 2ml Amikacian IA 2/8 11 tabs Pentoxy PO BID, 1 tab Prascend PO SID, 250# Gastroguard PO SID, 20 tabs Tylenol PO SID, 50ml Chloramphenicol PO TID, 20 ml Equiotic Paste PO SID, 2 gram Bute PO SID, 2ml Amikacian IA

2/9 11 tabs Pentoxy PO BID, 1 tab Prascend PO SID, 250# Gastroguard PO SID, 20 tabs Tylenol PO SID, 50ml Chloramphenicol PO TID, 2 gram Bute PO SID, Alexa was very uncomfortable and they noticed that she had sunken into her hoof and that she had a very bad case of laminitis. The rotation was big and the owners decided to euthanize because she was so uncomfortable even with morphine. Skills/Tasks Preformed: Restrain for joint flush/lavage ICU TPR, administer oral medications, apply let wraps, PRP.

Case #3 Signalment: 12 year old Chestnut Thoroughbred Mare Presenting Complaint: Colic, Temp 104 Positive Snap Test for Lyme, Gave 1ST Oxytetracycline Injection IV, grinding teeth, loosing weight, Urine is Dark, not eating well since Thursday 2/15 Diagnosis Test: Rectal, PE –TPR, Ultrasound, Abdominal Tap Diagnosis: Peritonitis Treatment Plan: 2/18 2PM -Admitted LRS 20L 3d/sec, 66ml/hr Lidocaine, 10mu Kpen IV QID, 22ml Baytril IV SID, 2.5ml Banamine IV TID 3PM Reflux : 5L 2/18 4PM 100.1 Temp HR:64 RR:12 LRS added 10L Total 30L 3d/sec – 10L Bolus, 66ml/hr Lidocaine, 10mu Kpen,

2/18 6PM HR: 44, Reflux 6L, No fluids added, Total Fluids 30L 2x Maintenance, 66ml/hr Lidocaine 2/18 8PM LRS added 10L, Total Fluids 40L 2x Maintenance, 66ml/hr Lidocaine. 2/18 12AM

PCV:45/T.S:8.8 Temp 102 HR: 60 RR:12 Reflux: 9L LRS Added 10L, Total Fluids 50L 5L bolus 2x maintenance, 66ml/hr Lidocaine, 10mu Kpen IV QID, 2.5ml Banamine IV TID 2/19 4AM Reflux: 2L LRS Added 10L Total Fluids 60L 2x Maintenance, 10mu Kpen IV QID

2/19 8AM Temp 100 HR:56 RR:12 Reflux 2L PCV:36/TS:7.8 LRS 0L Added Total Fluids 60L 3d/sec, 66ml/hr Lidocaine 2/19 12PM LRS 0L Added Total Fluids 60L 3d/sec 66ml/hr Lidocaine, 22ml Baytril IV SID 2/19 2PM Took Castle out to treatment bay to do an Abdominal Tap Lactate was 12.4 Fluid was Orange and Cloudy, TP:6.0, Plant Material was found in the Fluid and lots of Increased Free Bacteria. Owner was given the choice to do exploratory surgery or to euthanize and the owner decided to euthanize. Skills/Task Performed: Scrub for abdominal tap, Hook and unhook Patient for fluids, Ran CBC and lactate tests, read microscope slide where the plant material was found. Also assisted with necropsy....