3/28/2026

DVM Intake Exam Estimated age: ~10-12 yr Microchip noted on Intake? yes History: Stray Subjective: BAR Observed Behavior - growling during exam, but tolerated exam Is there evidence of suspected cruelty? No Objective: T = NT P = WNL R = WNL BCS 2/9 EENT: Eyes clear aside from LS OU, ears clean, no nasal or ocular discharge noted Oral Exam: missing dentition, moderate dental tartar, fractured dentition, swelling of gingiva over right maxillary canine and suspect retained root, possible other areas of retained roots PLN: No enlargements noted H/L: NSR, NMA, CRT < 2, Lungs clear, eupneic ABD: Non painful, no masses palpated, large soft bladder U/G: F presumed intact, no obvious spay scar or tattoo, no vulvar d/c, no obvious MGTs MSI: Ambulatory x 4, skin free of parasites, no masses noted, healthy hair coat CNS: Mentation appropriate - no signs of neurologic abnormalities Rectal: not performed Wood's Lamp Exam: not performed Assessment: ~10-12 yr FI DSH Underweight Severe dental disease Geriatric Prognosis: Fair Plan: Senior lab work with free catch UA to IDEXX (patient urinated on table-urine appears dilute) Pending labs recommend CXR/AXR to look for underlying disease given age and underweight Recommend dental and spay in house pending lab work, recommend preop CXR SURGERY: Temporary waiver due to underweight and pending labs

3/28/2026

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.

3/30/2026

Blood work results: CBC: L MCV (36) L MCH (11.9) H Monos (2.529) L eos (0) -noted that reactive lymphocytes present and microcytic anisocytosis and schistocytes-moderate CHEM: BG H (442) SDMA H (18) BUN H (61) H Na (178) H Cl (141) TT4: wnl UA: USG L (1.030) 3+ glucosuria A. Hyperglycemia r/o DM, DI vs stress (less likely due to other findings) microcytic anisocytosis and schistocytes-moderate r/o RBC fragmentation, pre-reg anemia, neoplasia vs artifact vs open Azotemia r/o pre-renal vs renal H SDMA r/o true renal vs artificially elevated d/t hydration status (creat wnl) Hypernatremia r/o hydration status vs DM/DI vs open Hyperchloremia r/o hydration status vs DM/DI vs open Sl L USG r/o primary renal vs open (free catch) glucosuria r/o second to diabetes P. Suspect DM Move p to medical if allows for behaviorally fluids (LRS) 75mL SQ SID x 3 days Spot BG today Start insulin 1unit prozinc BID indef in care with spot BG done either SID or BID pending behavior. Rec repeating bloods in 1 week to see if any abn have corrected themselves Diabetic monitoring sheet. Recheck tomorrow Seek placement - p has lifelong illness that will require ongoing care to maintain and is senior

3/30/2026

Addendum: Brought down to medical, noted to be drinking a lot of water- suspected that p was unable to reach food/water upstairs. Spot BG 505. Starting on insulin therapy. Given DM food signage CTM and recheck tomorrow

3/30/2026

Addedum 2: P eating well and comfy in medical. No need for fluids aTT, CTM and recheck BG tomorrow AM as scheduled, okay to give 1 unit of insulin tonight

3/31/2026

Brief progress exam - recheck DM on treatment S/O: QARH - friendly, leans into cheek scratches and purrs pink moist mm, CRT <2s skin turgor WNL no c/s/v/d reported P eating glycobalance very well Spot BG: 369 this AM --> 1U prozinc SQ administered A: DM - Improvement in BG / clinical symptoms since starting prozinc yesterday P: CWCT DVM recheck 4/2 Seek placement, added to ARL - p has lifelong illness that will require ongoing care to maintain and is senior

Upon intake Daisy Cake was friendly and tolerant with staff. She allowed all handling.