1 year old male Beagle

Diagnosis

• Smoke inhalation

Discharge summary of two weeks of care in the intensive care unit:

Severe pulmonary dysfunction initially, requiring mechanical ventilation for first 24 hours. Marked quantities of hemorrhagic effusion emptied from ETT with postural drainage. Serial chest radiographs showed severe diffuse alveolar pattern initially with marked improvement to diffuse bronchial infiltrates by time of discharge. Initially cough producing tenacious mucous and airway casts. Later, persistent dry hacking cough treated with butorphanol initially and hydrocodone at discharge. Pulmonary function markedly compromised initially, improved to A-a gradient of 26 at discharge.

EYES: Bilateral corneal ulcers present initially. treated with BNP, serum, and puralube q2h. Corneal ulcers completely resolved by time of discharge.

OROPHARYNX: Unable to be extubated post ventilator weaning due to severe oropharyngeal edema/inflammation. Tracheostomy tube placed. Oropharyngeal inflammation resolved, tracheostomy tube removed, Stoma almost completely healed by time of discharge.

NEUROLOGICAL: 2 seizures shortly after presentation, prior to being started on mechanical ventilation. Post-extubation, unable to ambulate normally, cortically blind. Vision returned, exhibiting markedly compulsive behavior. Compulsive behavior improved, persistent PL ataxia remained. By time of discharge, no further neurological deficits were apparent.