3/17/2024

Your newly adopted pet is overage and the staff veterinarians are issuing a PERMANENT waiver from the spay/neuter requirements of the City of NY. ACC does not have the facility to safely sterilize your pet with his/her current condition. However, your veterinarian will provide consultation on whether this procedure can or should be performed under their supervision. Follow up care at your regular veterinarian is recommended to ensure continued treatment and proper oversight of your pet's health. All costs for follow up care and subsequent surgery is at the expense of the adopter.

3/17/2024

DVM Intake Exam Estimated age: 10-12 y/o based on dentition and ocular exam Microchip noted on Intake? scan negative History: Owner surrender Subjective: BARH Observed Behavior - friendly, easy to handle and tolerated exam and procedures well Is there evidence of Cruelty? no Is there evidence of Neglect? no Is there evidence of Trauma? no Objective T = not taken P = wnl R = wnl BCS 4/9 EENT: Nuclear sclerosis OU, AS- thick brown waxy discharge clumped together with hair at canal opening, moderate erythema; no nasal or ocular discharge noted Oral Exam: moderate to severe dental disease, moderate tartar and gingivitis PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupnic ABD: Non painful, bladder feels thickened and firm, possibly enlarged prostate U/G: 2 testes in scrotum; dark brown/red urine on table, posturing then dribbling MSI: Ambulatory x 4, bilateral grade 3/4 luxating patellae; skin free of parasites, no masses noted, dull hair coat; 2 cm round SQ mass on dorsum; CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: 3 inch mass ventral; slightly firm 3-inch SQ ulcerated mass/swelling under anus to right of midline with mild amount of serous discharge Wood's Lamp Exam: not performed Assessment: ~10-12 y/o intact male Otitis externa OS Dental disease grade 3/4 Nuclear sclerosis Small SQ mass on dorsum Ulcerated mass R perianal region r/o anal gland abscess vs neoplasia, (anal gland adenocarcinoma) Bilateral luxating patellae Hematuria r/o prostatitis, BPH, urolithiasis, neoplasia Prognosis: Guarded to fair Plan: *Cleaned AS with Aurocin and applied Simplera into each canal *Collected blood and urine for CBC/Chem/TT4 and urinalysis, recheck Idexx results on 3/18 *Determine next steps, radiographs +/- abdo POCUS in house depending on results of bloodwork and urinalysis *Administered carprofen 4.4mg/kg SQ once. Consider continuing carprofen PO if bloodwork does not show liver and kidney disease *Start Clavamox 125mg PO q12h x 7 days, 3/17-3/23 *P will need a full-abdominal ultrasound with placement to investigate underlying diseases. Recommend NH only placement. SURGERY: Permanent waiver due to age

3/18/2024

Recheck senior dog with hematuria and perianal mass BAR, excellent appetite- multiple empty bowls. Perianal area as previously described- two ulcerated areas with scabbing, no discharge or other signs of infection. Friendly but would not allow handling of hind end. CBC: MCH 21.5 (L), reticulocyte hemoglobin 24.0 (L), platelets 467 (H) Chem: WNL UA: Red colored, USG 1.040, urine protein 3+ (H), blood/hemoglobin 3+, WBC 20-30 (H), RBC >100 (H) Interpretation: NSF on CBC/chem. Hematuria confirmed. Pyuria present with no bacteria- suspect secondary to benign prostatic hypertrophy, UTI less likely. A: ~10-12 y/o intact male Otitis externa OS Dental disease grade 3/4 Nuclear sclerosis Small SQ mass on dorsum Ulcerated perianal areas- r/o healing anal gland abscess vs neoplasia Bilateral luxating patellae Hematuria r/o BPH vs. neoplasia vs. urolithiasis vs. prostatitis/other Plan: Discontinue Clavamox- not medically indicated Not extending Carprofen as patient appears comfortable Recommend veterinary follow-up with placement. Recommend neuter to decrease signs of likely prostatic disease + further evaluation of perianal masses and luxating patellae

3/19/2024

Start trazodone 7 mg/kg PO q12 indefinitely for FAS- vocalizing for attention in kennel.

3/22/2024

Recheck senior dog S/O: BAR, allows petting but growls a bit when removing from kennel Eating well, no c/s/v/d noted Oral: mm pink and moist, moderate tartar visible No ocular or nasal discharge No hematuria noted or reported Eupneic Anal mass 1 - small nodule approx 0.5cm at right dorsal aspect of anus, pressure applied and pink tissue expressed from draining tract Anal mass 2 - larger 3-4 cm region of mass effect/swelling at right ventrolateral aspect of anus with two palpable nodules within larger mass (each approx 1cm), draining tracts that are scabbed over with no active discharge Small 1cm dermal nodule palpated at mid dorsum just right of midline A: Anal masses/nodules - ro anal gland neoplasia vs impacted/infected anal glands vs other Senior pet Dental disease Hematuria - not noted today Otitis externa OS MPLs Small SQ/dermal mass on dorsum P: CTM while at BACC, hematuria apparently resolved Recommend surgical consult for anal masses, recommend biopsy Also consider dental procedure and neuter with placement

3/26/2024

Brief recheck - S/O: BAR, active and barking in kennel, growls initially when approached, but allows petting and exam Eating, no c/s/v/d noted No ocular or nasal discharge No hematuria noted or reported Eupneic A: Anal masses/nodules - ro anal gland neoplasia vs impacted/infected anal glands vs other Senior pet Dental disease Hematuria - resolved Otitis externa OS MPLs Small SQ/dermal mass on dorsum P: CTM while at BACC Recommend surgical consult for anal masses, recommend biopsy Also consider dental procedure and neuter with placement