7/30/2026

It is the policy of ACC not to perform surgery on any animal over the age of 8-10 years due to the higher risks incurred in a shelter setting. The veterinarian is hereby issuing a permanent spay/neuter waiver, from the spay/neuter requirements of the City of NY due to the estimated age of this animal. ACC does recommend you consult with your veterinarian to determine if surgical sterilization is appropriate.

7/30/2026

DVM Intake Exam Estimated age: approx 10-15 years based on dentition and conformation Microchip noted on Intake? scanned negative History: stray - finder reported wounds Subjective: QAR Observed Behavior - solicits attn, allowed for handling and tasks Is there evidence of suspected cruelty? N Objective: T = np P = wnl R = wnl BCS 2/9 EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: missing most visible dentition, moderate-severe wear and staining to visible dentition, pale/tacky mm PLN: No enlargements noted H/L: NSR, 4/6 holosystolic HM, CRT < 3, Lungs clear, eupneic ABD: Non painful, no masses palpated, doughy U/G: MI, two scrotal testes MSI: Ambulatory x 4, prolonged skin tent, multifocal regions of wounds with scabbing and carious stages of healing to the right side of the face, right axillary region, bilaterally to the hocks and medial aspect of the L hock, scattered regions of focal alopecia along the dorsum CNS: Mentation appropriate - no signs of neurologic abnormalities Wood's Lamp Exam: negative In house BW: CBC: HCT L (19.6) H Retics (62.4) H WBCs (17.99) w H neuts (15.62) r/o stress vs inflam leuk H platelets (789) r/o reactive CHEM: H BUN (48) L phos (2.4) r/o losses Assessment: Geriatric - suspect chronic conditions underweight muscle wasted dehydrated wounds- healing r/o caustic vs open heart murmur anemia with regenerative Prognosis: guarded pending recheck tomorrow Plan: intake exam and tasks 100mL SQF SID x 3 days (first dose given during exam vit B12 0.25mL SQ applied SSD to wounds convenia 8mg/kg SQ once (0.27mL) recheck tomorrow with AUS- suspect abdominal mass d/t doughy abdomen awaiting sort SURGERY: Okay for surgery: N Permanent waiver due to age

7/31/2026

S: Recheck for sedated radiographs and ultrasound. Geriatric feline with multiple wounds throughout body. Abdomen palpated abnormal on intake. In house BW 7/30: CBC: HCT L (19.6) H Retics (62.4) H WBCs (17.99) w H neuts (15.62) r/o stress vs inflam leuk H platelets (789) r/o reactive CHEM: H BUN (48) L phos (2.4) r/o losses EENT: Eyes clear, ears clean, no nasal or ocular discharge noted Oral Exam: missing most visible dentition, moderate-severe wear and staining to visible dentition, pale/tacky mm PLN: No enlargements noted H/L: NSR, 4/6 holosystolic HM, CRT < 3, Lungs clear, eupneic ABD: Non painful, thickened intestines on palpation with a doughy abdomen. Kidneys palpate large bilaterally. U/G: MI, two scrotal testes MSI: Ambulatory x 4, prolonged skin tent, multifocal regions of wounds with scabbing and carious stages of healing to the right side of the face, right axillary region, bilaterally to the hocks and medial aspect of the L hock, scattered regions of focal alopecia along the dorsum CNS: Mentation appropriate - no signs of neurologic abnormalities Abdominal radiographs: Decreased serosal detail. Large urinary bladder. Very enlarged stomach with intestines comprised of food/gas. Abdominal ultrasound: Spleen appears to have a slightly abnormal margin. Liver appears wnl. Very large and gas-filled stomach. Urinary bladder is very large with slight debris present in contents (r/o crystals vs. other). Scan free-fluid noted in caudal abdomen (around urinary bladder and caudal SI). Assessment: Geriatric - suspect chronic conditions underweight muscle wasted dehydrated wounds- healing r/o caustic vs open heart murmur anemia with regenerative Scant free-fluid in abdomen P: Given comorbidities, consider placing deadline after strayhold has finished. No additional treatments needed at this time. Recheck scheduled for 8/2 to evaluate progress and determine if ARL vs. deadline is appropriate.

7/31/2026

See previous note today.

8/3/2026

Recheck exam BAR, eating very well in care. No ODC/NDC. No lymph node enlargement. Abdomen remains non-painful, doughy in palpation. Ambulatory x4, multifocal regions of healing wounds. Appropriate mentation A: Geriatric Underweight - *Weight gain noted today* Dehydrated Wounds - healing Heart murmur Regenerative anemia P: Weight gain is promising. Consider discussing at ARL meetings to determine pathway and next steps. patient should remain on ARL list +/- with deadline. Recheck placed 8/5 to evaluate progress.

8/7/2026

Recheck exam/evaluate QOL BAR, eating very well in care. No ODC/NDC. No lymph node enlargement. Abdomen remains non-painful, doughy in palpation. Muscle wasting along epaxials. Ambulatory x4, multifocal regions of healing wounds. Appropriate mentation A: Geriatric Underweight - *Weight gain noted today* Dehydrated Wounds - healing Heart murmur Regenerative anemia P: Patient is clinically stable and is gaining weight with no clinical signs of vomiting/diarrhea. ARL updated, recommend placement for additional supportive care (TLC) +/- diagnostics if needed in the future.