1/24/2025

Your newly adopted pet has been diagnosed with neurological signs and the staff veterinarians are issuing a TEMPORARY waiver from the spay/neuter requirements of the City of NY. Follow up care at your regular veterinarian is recommended to ensure continued treatment through to the resolution of the issue. At the time of a full recovery you may choose to have your veterinarian perform the spay/neuter surgery, or make provisions to return the pet to ACC for sterilization.

1/24/2025

DVM Intake Exam Estimated age: ~1-2 years, small testicles, mild jowls present Microchip noted on Intake? N History: Stray. Finder noted shaking and took to vet, where amoxicillin was prescribed and SQF given- records not available. Subjective: Observed Behavior - Stress meowed, allowed handling. Struggled and vocalized for blood draw. Is there evidence of Cruelty? N Is there evidence of Neglect? N Is there evidence of Trauma? N Objective BCS 5/9 EENT: Eyes clear, moderate debris AU, no nasal or ocular discharge noted Oral Exam: Clean adult dentition H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated, tense abdomen U/G: MI, two scrotal testes MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate, severe hindlimb tremors especially when patient touched. At rest, minimal tremors noted Rectal: Externally normal Assessment Tremors- r/o infectious (toxoplasmosis, FIP, other) vs. toxin vs. other (stress, pain, congenital, electrolyte imbalance, etc.) Prognosis: Fair Plan: Sent out CBC/chem Recheck tomorrow with bw eval Consider clindamycin for empirical toxo treatment Cleaned ears SURGERY: Temporary waiver due to neurological signs

1/26/2025

BW results and recheck S/O QAR, begins to low growl, and hiss when approached, begins to have generalized tremors when attempted handling (appears to start in the legs and move upwards toward the body). Visual only to reduce stress, noted to be not eating EENT: no ocular or nasal dc HL: eupneic MSI: sitting in den, no visible lesions A. Tremors when excited r/o primary neuro vs secondary (infectious-toxo vs immune) Hyporexia in care P. MF BID x 5 days Clinda for empirical toxo tx not start aTT d/t p not eating and behavior. Recheck in 2 days for appetite, if less stress, full PE Blood work results CBC: sl leukocytosis w lymphocytosis (8.5) CHEM: Creat sl L (0.7) sl hypochloremia (113) TT4 wnl A/P Lymphocytosis r/o antigenic No change in tx aTT

1/28/2025

Brief recheck - BAR in den, growls when approached, eating well, tremors not noted at rest. Plan: Full PE tomorrow. Won't be able to give oral medication (clindamycin) due to behavior. Large volume (2ml dose) unlikely to be eaten in food. Seek placement.

1/29/2025

Recheck exam S/O: QAR in den, shies away from handling, but does allow it. No growling or hissing today. Eating very well, two empty dishes in kennel No c/s/v/d noted EENT: No ocular or nasal discharge Oral: mm pink, mild tartar caudally LUNGS: Eupneic ABD: No masses palpated, large soft urinary bladder MSI: Mild-moderate diffuse muscle wasting, pelvic limbs more notably than forelimbs. Underweight, BCS 2-3/9. No tremors at rest in kennel, once he stands to begin coming out of den and once he is out of den (standing or walking) significant tremoring noted, begins and is more notable in pelvic limbs. Healthy haircoat, mild skin tent. CNS: Appropriate mentation, tremors as described above Dexmedetomidine 0.1 ml + butorphanol 0.1 ml IM + ketamine 0.1 ml IM. Full antisedan reversal, smooth recovery. 2VAXR - decreased serosal detail, stool throughout descending colon, mixed opacity material/ingesta in stomach 2VTXR - cardiac silhouette unremarkable, no significant findings Pelvis/limbs - stool obscures some pelvic margins, but no obvious abnormalities A: Tremors - absent at rest, present when standing/walking. Rule out infectious vs toxin vs other Underweight, diffuse muscle atrophy Mild dental disease Mild dehydration P: Sedated rads today, neutered while sedated Urine obtained via cysto - submitted for UA Start SQ LRS 150 ml SID x 3 days Start clindamycin 16 mg/kg PO BID x 4 weeks *higher dose in order to give capsule over liquid (would be large volume of suspension) CTM closely in ICU, seek placement for neuro workup

1/29/2025

Routine Feline Neuter Single incision over midline of scrotum, sharp dissection to exteriorize each testicle Self tie of spermatic cords Green linear tattoo placed Surgeon: 1438 Additional Note: Smooth recovery, onsior 2 mg/kg given SQ