PCV/TP Collection date 2024-10-12 11:00:00 PCV 29 % TS 5.2 g\dl Serum clear

Blood lead Collection date 2024-10-12 Level 5.40 ug/dL

Surgery report Procedure - Pellet removal Performed by - Dr G Surgery time - 30 minutes While in the radiology room placed two 23 ga needles to try to pin-point area of pellet. Preserving the needles, moved upstairs and placed bird in sternal recumbency. Incised through skin of shoulder dorsal and slightly caudal to point of shoulder, this is the area that seemed most likely to be the location of the pellet. Bluntly dissected muscle in that location and located a thin bone there. However, I was able to dissect just behind that bone and there was a bit of a divot that I thought I could see gray through. After a little more blunt dissection I was able to grab the end of the pellet with hemostats and pull it out, along with some debris and feathers. Explored the pocket a bit more and pellet out a large piece of exudate, then some smaller pieces of debris. I was afraid to flush directly into the pocket in case of penetration to the thorax or the air sacs, but wet some sterile Q-tips and debrided the pocket well, removing some smaller pieces of debris. Dribbled 0.05 ml of Lidocaine over surgery site (muscle and skin - avoiding pocket). Oppposed muscles with 4-0 PDS in a horizontal mattress pattern. Closed skin w/ a Ford Interlocking pattern, 4-0 PDS. Post-op radiographs showed a bit of a deficit in the area that the pellet was in, and the fracture fragment appeared to have sunken down a bit ventrally. Placed a figure-8 with a body wrap to immobilize right shoulder. Bandage change and PT under anesthesia every 3 days for at least a week, at that point can try to leave off but should continue PT aggressively for at least 2 weeks to prevent the shoulder from stiffening. Dr Gardner

PCV/TP Collection date 2024-10-07 11:37:00 PCV 26 % TS 5.4 g\dl Serum pale straw

Blood lead Collection date 2024-10-07 Level 9.30 ug/dL

CBC Collection date 2024-10-07 WBC count 43000 Corrected count 24844 Hets/Neut 65% - 16148   Bands 3+   Toxics 0+ Lymphs 28% - 6956 Eos 4% - 993 Mono 2% - 496 Baso 1% - 248 Thrombocytes PI 2 Hemoproteus NEG Leukocytozoon NEG Plasmodium NEG Read by cd ~1/3 hets are banded or unsegmented. One het with toxic markers, some degranulated. Minimal blasts seen.

PCV/TP Collection date 2024-10-02 12:01:00 PCV 27 % TS 5.4 g\dl Serum cloudy pale straw, hemolyzed

Blood lead Collection date 2024-10-02 Level 5.60 ug/dL

CBC Collection date 2024-10-02 WBC count 38000 Corrected count 22800 Hets/Neut 60% - 13680   Bands 3+   Toxics 0+ Lymphs 29% - 6612 Eos 8% - 1824 Mono 1% - 228 Baso 2% - 456 Thrombocytes PI 2 Hemoproteus 1+ Leukocytozoon NEG Plasmodium NEG Read by cd Many immature het forms, only one toxic cell seen. Monocyte count may be off - odd forms seen, immature? Hemoproteus infection still very mild.

Physical therapy Limb/joint Right wing Type   Elbow Wrist Before 130 180 After 140 180 Notes ROM on shoulder is stiff, could not get full motion. Extension of wing normal after a few tries.

Surgery report Procedure - Wound debridement Performed by - RMB Surgery time - 0 minutes Placed under 3.5 5 ISO via mask for wound care and PT. Was very wraspy when grabbed, comed down once under ISO. Heart rate was stable throughout. Stitches are nice and dry, did cover with a little SSD. After PT wrap wing back in padding and figure 8 wrap with body wrap. Noted that the right elbow is dark green and slightly swollen, probably from blood draw on Wednesday.

Surgery report Procedure - Pellet removal Performed by - Dr. Ritzman Surgery time - 35 minutes Surgical Attempt at Lead Pellet Removal, Right Shoulder Area: Patient placed under general anesthesia and positioned in dorsal recumbency. The area of the right shoulder and thoracic inlet on the right side was prepared for sterile surgery. A focal incision was made with #15 blade over the area of the proximal right corocoid bone (this approach was chosen based on radiography findings). Gentle blunt dissection performed with saline soaked q tips and small hemostats to divide between the muscle and soft tissues of this area. The proximal right corocoid was identified. Extensive palpation and visual exam did not reveal the lead pellet. Small bone ronguers were used to gently scrape and remove surface layer of bone of the proximal corocoid. It was still not possible to identify or find the pellet. After exam in this area it was decided to stop surgery and close the area to avoid undue trauma to the tissues in this area. Sterile saline flush then closure with 4-0 vicryl in simple continuous pattern for subcuticular tissues, subdermal layer and then dermis with simple continous pattern. Small amount of tissue adhesive placed along dermis incision line. Light padded figure 8 to body wrap was performed to support the wing for a few days post op. Sutures can be removed in 10-14 days. Blood lead retest performed today. Patient recovery from anesthesia was uneventful and normal. Dr. Tracey Ritzman,DVM, Dipl. ABVP-Avian & ECM

PCV/TP Collection date 2024-09-25 14:20:00 PCV 24 % TS 5.5 g\dl Serum pale straw

Blood lead Collection date 2024-09-25 Level 0.00 ug/dL

CBC Collection date 2024-09-25 WBC count 61800 Corrected count 32960 Hets/Neut 69% - 22742   Bands 3+   Toxics 0+ Lymphs 26% - 8569 Eos 4% - 1318 Mono 1% - 329 Baso 0% - 0 Thrombocytes PI 3 Hemoproteus 1+ Leukocytozoon NEG Plasmodium NEG Read by cd Morphology hasn't changed significantly since last read on 9/20. Hemoproteus infection is evidently lingering but very mild, saw 3 cells with halter forms around nuclei. High buffy %, hemolyzed, Dr Tracey agrees with indication of band presence.

PCV/TP Collection date 2024-09-20 10:42:00 PCV 28 % TS 4.8 g\dl Serum clear

Blood lead Collection date 2024-09-20 Level 10.40 ug/dL

CBC Collection date 2024-09-20 WBC count 60200 Corrected count 37457 Hets/Neut 57% - 21350   Bands 2+   Toxics 0+ Lymphs 27% - 10113 Eos 8% - 2996 Mono 7% - 2621 Baso 1% - 374 Thrombocytes PI 3 Hemoproteus NEG Leukocytozoon NEG Plasmodium NEG Read by cd Total count is a bit lower than last count. Less immature het forms seen. Some mono & lymphs seem reactive and some hets are much smaller than usual.

PCV/TP Collection date 2024-09-12 10:57:00 PCV 35 % TS 5.2 g\dl Serum pale yellow

Blood lead Collection date 2024-09-12 Level 7.80 ug/dL

CBC Collection date 2024-09-07 WBC count 79600 Corrected count 79600 Hets/Neut 72% - 57312   Bands 2+   Toxics 0+ Lymphs 13% - 10348 Eos 9% - 7164 Mono 6% - 4776 Baso 0% - 0 Thrombocytes PI 2 Hemoproteus NEG Leukocytozoon NEG Plasmodium NEG Read by cd High total count, heterophilia / lymphopenia. PI high end of 2, saw some suspected very immature rbcs. Fair amount of blast cells. Banded hets of varying degrees - close to 40% affected.

Physical therapy Limb/joint Right wing Type PROM   Elbow Wrist Before 90 120 After 140 180 Notes A little stiff in the elbow. Otherwise full rom quickly. no ane used

Fecal Collection date 2024-09-04 Results NEG	Fecal Collection date 2024-09-04 Results POS for capillaria	PCV/TP Collection date 2024-09-04 12:23:00 PCV 26 % TS 4.4 g\dl Serum clear
Blood lead Collection date 2024-09-04 Level 6.80 ug/dL	CBC Collection date 2024-09-04 WBC count 21800 Corrected count 12595 Hets/Neut 57% - 7179   Bands 2+   Toxics 1+ Lymphs 25% - 3148 Eos 7% - 881 Mono 11% - 1385 Baso 0% - 0 Thrombocytes PI 2 Hemoproteus 1+ Leukocytozoon NEG Plasmodium NEG Read by cd See CBC notes in chart. Mild monocytosis. Bands are strong when present, toxic cells are few and far between with minimal markers. Fair amount of poikilocytes. Reactive clusters.

Eye exam Exam date - 2024-09-02 Examiner - sc RIGHT LEFT PLR Menace PLR Menace + + + + Stain   Stain   DNE   DNE   Right eye: Overall WNL Left eye: Overall WNL

Eye exam Exam date - 2024-09-01 Examiner - RMB/JK RIGHT LEFT PLR Menace PLR Menace + ++ + ++ Stain   Stain   DNE   DNE   Right eye: PLR weak and incomplete; NSF otherwise. Left eye: PLR weak and incomplete; NSF otherwise.