10/12/2026

DVM Intake Exam Estimated age: ~10-13 years based on dentition / eyes / condition Microchip noted on Intake? Scanned positive History: Stray Subjective: Prior to sedation - BAR pink moist mm, CRT <2s Observed Behavior - easily approachable, allowed handling. sedated for safety and comfort for x-rays and matt shave down Is there evidence of suspected cruelty? YES Objective: P = WNL (sedated) R = WNL (sedated) BCS 4.5/9 EENT: Cataracts OU, ears clean, no nasal or ocular discharge noted Oral Exam: Severe dental disease. Gingival recession and moderate tartar on top incisors. Missing multiple teeth. Severe dental tartar on remaining molars & premolars. Gingival mass on upper left quadrant. PLN: No enlargements noted H/L: NSR, NMA, CRT < 2s, Lungs clear, eupneic ABD: Soft, nonpainful, no masses palpated U/G: Male - intact, two symmetrical scrotal testicles MSI: Prior to sedation - Ambulatory x 4, abnormal bone thickness around left elbow- uncomfortable when touched. INT: Severe hair matting with foul smell, no masses noted, no ectoparasites seen CNS: Prior to sedation - Mentation appropriate - no signs of neurologic abnormalities Rectal: No palpable masses or strictures; normal brown stool on exam glove. Wood's Lamp Exam: Not performed Assessment: MI senior canine underweight Severely matted Severe dental disease Gingival mass Abnormal bone thickness on left elbow- suspect old, healed fracture Prognosis: Good Plan: SEDATED --> dexmedetomidine 0.1mL, butorphanol 0.1mL IM --> moderate sedation achieved Antisedan 0.1mL IM for reversal --> P sternal prior to leaving exam room front limb radiographs: structural remodeling of bone around left elbow -suspect old, healed fracture on left elbow. Chest radiographs: no obvious rib fractures, suspect enlarged heart: added probnp to bloodwork Bloodwork & UA sent out - Adult wellness with UA & probnp- results * PENDING * OK for appropriate intake tasks ADD Gabapentin 100mg (~16mg/kg) PO BID TFN Recommend dental assessment after placement SURGERY: Okay for surgery pending bloodwork results.

10/15/2026

Blood work results: CBC: monocytosis (1.46) r/o inflammation second to dental dz CHEM: hypoglycemia (55) r/o artifact, nutritional status upon arrival hypochloremia (106) r/o losses, shifts L albumin (2.3) r/o losses, open H ALP (198) r/o second to blood draw proBNP H (1,343) TT4 L (0.9) r/o sick euthyroid A. H proBNP consistent with structural cardiac dz, p noted to have cardiomegaly upon intake rads P. P will receive permanent waiver for cardiac disease recheck in 3 days and re-auscultate. Seek placement, p would benefit from cardiac consult/echo CTM while at QACC

10/18/2026

DVM Progress Exam S/O: -BAR. E/D well, no C/S/V/D. -Cardiac auscultation repeated today: Grade II/VI systolic heart murmur, PMI left heart base. -Based on dentition, ocular changes and overall condition, suspect patient is older than previously estimated, likely approximately 12-15 years. A: -Grade II/VI systolic heart murmur, PMI left base -Elevated proBNP with suspected cardiomegaly, consistent with structural cardiac disease -Geriatric canine, suspect approximately 12-15 years P: -Placed Canine Daily Monitoring Log -New Hope placement ASAP -Recommend cardiology consultation/echocardiogram after placement -Permanent surgical waiver due to cardiac disease/advanced age -CTM through routine shelter operations

10/20/2026

Progress exam: Sneezing noted on monitor log Subjective: BAR, no C/V/D. Sneezing/sniffling noted Objective: EYES: Clear LUNGS: Eupneic, no sign of respiratory distress NASAL CAVITY: mild serous discharge MUSCULOSKELETAL: Ambulatory x4, no lameness or lesions NEURO: Appropriate mentation ASSESSMENT: Presumed CIRDC PLAN: Per standing orders -Under the weather sign, ppe sign & monitor log placed on kennel. -Start doxycycline 100mg PO SID x10 days -CTM, recheck as scheduled

10/22/2026

Brief recheck: BAR, Sniffly & mild congestion noted. AS:3 eats wet food great. Mild serous nasal discharge, no ocular discharge noted. CTM, recheck as scheduled.

10/23/2026

Brief recheck MRS notes hyporexia -- mildly prolonged skin tent but BAR --> gave LRS 120mL and vitB12 1cc SQ and P ate very well after. CWCP and rechecks as scheduled

10/24/2026

Progress exam S/O: Initially did not eat this AM, then when returned food bowl was empty. Ate sausages eagerly when hand fed. P is QAR, brighter on interaction; lethargic, copious mucoid nasal discharge from nares and occasional sneezing. Increased expiratory effort with slightly increased bilateral lung sounds, pink mm. Heart murmur grade 2/6 continued as previously noted. A: -CIRDC -Severe dental disease -Cardiac disease, heart murmur with elevated proBNP -Healed elbow fracture -Geriatric P: Extend supportive care and add injectable enrofloxacin: -LRS SQ 100ml x 5 days -Cerenia 0.6ml SQ x 5 days -Enrofloxacin 0.6ml SQ x 5 days *Add to ARL for medical due to comorbidities and CIRDC *If becomes anorexic or respiratory status deteriorates, recommend EHR

10/25/2026

Progress exam S/O: Poor appetite this AM but ate treats well when hand fed, ate food with fair appetite in PM. P is QAR, BAR on exam, mild mucoid nasal discharge from nares and occasional sneezing. RE WNL, slightly increased bilateral BV sounds, pink mm. Heart murmur grade 2/6 continued as previously noted. A: -CIRDC -Severe dental disease -Cardiac disease, heart murmur with elevated proBNP -Healed elbow fracture -Geriatric P: CWCP, extended medical feedings --> 10/28 DVM recheck 10/26

Upon intake, friendly and allowed all handling.